在子宫内膜息肉中腺体拥挤:临床随访和可能令人担忧的特征
Nermin Koç1, Ayşe Deniz Ertürk Coşkun2
1Department of Pathology, University of Health Sciences Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
International journal of surgical pathology
|December 8, 2023
概括
在子宫内膜聚体中焦点腺拥挤可以表明患有前瘤变化的风险. 显示PAX2损失或细胞学变化的初始活检表明在随访中,子宫内皮内瘤 (EIN) 的可能性更高.
科学领域:
- 妇科病理学 妇科病理学
- 生殖医学 生殖医学
- 在瘤学瘤学.
背景情况:
- 解释子宫内膜聚中的变化和前恶性病变会带来诊断挑战.
- 在子宫内膜片中聚焦腺拥挤需要仔细评估潜在的恶性转变.
- 在初始活检中识别预测性形态标记对于管理患者结果至关重要.
研究的目的:
- 为了评估患者的临床过程与焦点腺拥挤在子宫内膜的息肉.
- 在初始活检中识别可能预测癌前病程的形态发现.
- 为了将重复活检发现与初始组织学特征相关联.
主要方法:
- 重新检查子宫内膜异位体标本与焦点腺拥挤和可用的重复活检在一年内.
- 从初始活检中记录形态发现.
- 在患有良性重复活检和患有前恶性或恶性发现 (子宫内皮内瘤 - EIN) 的患者之间比较初始活检特征.
主要成果:
- 在经过重复活检的38名患者中,8名 (21%) 被诊断为EIN (第一组) 和30名 (79%) 患有良性发现 (第二组).
- 在第一组 (75%) 的PAX2损失明显高于第二组 (23% (P=.020) 的损失.
- 改变的上皮细胞学特征在第一组 (62%) 与第二组 (13%) (P=.015) 中也明显更为普遍.
结论:
- 在子宫内膜聚合体中焦点腺拥挤与在随后的活检中发展子宫内膜内皮质瘤 (EIN) 的风险有关.
- 在初始活检中,PAX2表达的丧失或减少以及上皮细胞学的改变是潜在的癌前病程的指标.
- 这些发现有助于对患有子宫内膜聚的患者进行风险分层和管理.
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