Stromal p16 Expression Helps Distinguish Atypical Polypoid Adenomyoma From Myoinvasive Endometrioid Carcinoma of the Uterus
Stromal p16 Expression Helps Distinguish Atypical Polypoid Adenomyoma From Myoinvasive Endometrioid Carcinoma of the Uterus
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DOI：
10.1097/pas.0000000000001320
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发表时间：
2019-11-01
影响因子：
5.6
通讯作者：
Niki, Toshiro
中科院分区：
文献类型：
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作者：
Kihara, Atsushi;Amano, Yusuke;Niki, Toshiro
非典型息肉样腺肌瘤（APA）是由非典型子宫内膜腺体和纤维肌性间质组成的息肉样病变，病理学家经常将其与肌浸润性子宫内膜样癌混淆。在这里，我们对 APA 基质成分的免疫组织化学和分子特征进行了表征，以寻找 APA 和肌浸润性子宫内膜样癌之间的独特标记物。首先，我们使用 12 例 APA 检查了之前在子宫和乳腺纤维上皮病变中研究的免疫组织化学表达和基因突变。在所有病例中，α-平滑肌肌动蛋白在基质成分中呈弥漫性阳性，而结蛋白和 h-caldesmon 在 8 例中呈局灶性表达。 CD10阳性表达9例，雌激素受体阳性表达12例，HMGA2阳性表达3例，MDM2阳性表达3例。所有病例均显示正常的p53表达以及HMGA1和核β-连环蛋白的阴性染色。在任何情况下均未发现 MED12 外显子 2 和 TERT 启动子发生突变。 p16在所有病例中均呈阳性，其中10例呈弥漫性表达。我们评估了 84 例肌浸润性子宫内膜样癌的间质 p16 表达。所有肌浸润性癌的间质p16状态均为阴性，但有1例出现局灶性染色。 APA 与肌浸润性子宫内膜样癌间质 p16 表达存在显着差异（P
Atypical polypoid adenomyoma (APA) is a polypoid lesion that is comprised of atypical endometrial glands and fibromuscular stroma, which pathologists often confuse with myoinvasive endometrioid carcinoma. Here, we characterized the immunohistochemical and molecular features of the stromal components of APA to find distinct markers between APA and myoinvasive endometrioid carcinoma. First, we examined the immunohistochemical expression and gene mutations that were previously investigated in uterine and breast fibroepithelial lesions using 12 cases of APA. alpha-smooth muscle actin was diffusely positive in the stromal component in all cases, whereas desmin and h-caldesmon were focally expressed in 8 cases. Positive expression was also observed in 9 cases for CD10, 12 cases for estrogen receptor, 3 cases for HMGA2, and 3 cases for MDM2. All cases showed normal p53 expression and negative staining of HMGA1 and nuclear beta-catenin. No mutations in MED12 exon 2 and the TERT promoter were found in any cases. p16 was positive in all cases and showed diffuse expression in 10 cases. We assessed stromal p16 expression in 84 cases of myoinvasive endometrioid carcinoma. The stromal p16 status was negative in all myoinvasive carcinomas, but there was 1 case with focal staining. There was a significant difference in stromal p16 expression between APA and myoinvasive endometrioid carcinoma (P