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  • 期刊

高惡性度子宮內膜基質肉瘤的病理診斷

摘要


子宮內膜基質瘤(endometrial stromal tumor, EST)屬於少見的婦女生殖道間質腫瘤,具有多樣化的臨床與組織學表現。由於缺乏特異性的免疫組織化學染色,且病理特色可能類似於惡性平滑肌瘤或其他間質腫瘤,子宮內膜基質瘤的病理診斷一直相當具有挑戰性,分類也莫衷一是。近年,隨著次世代基因定序等分子病理方法學的快速進展,子宮內膜基質瘤的診斷與分類逐漸清晰,依據最新版的世界衛生組織腫瘤分類系統,子宮內膜基質瘤共有4大類,分別是子宮內膜基質結節(endometrial stromal nodule, ESN)、低惡性度子宮內膜基質肉瘤(low-grade endometrial stromal sarcoma, LGESS)、高惡性度子宮內膜基質肉瘤(high-grade endometrial stromal sarcoma, HGESS),與未分化子宮肉瘤(undifferentiated uterine sarcoma, UUS),各自有獨特的臨床表現、組織病理型態、免疫組織化學染色特性,與基因變異。其中,高惡性度子宮內膜基質肉瘤是最困難診斷的類別,也最需要分子病理的輔助。

參考文獻


Yen MS, Chen JR, Wang PH, et al. Uterine sarcoma part III-targeted therapy: the Taiwan Association of Gynecology (TAG) systematic review. Taiwan J Obstet Gynecol 2016;55:625-34.
Hemming ML, Wagner AJ, Nucci MR, et al. YWHAE-rearranged high-grade endometrial stromal sarcoma: two-center case series and response to chemotherapy. Gynecol Oncol 2017;145:531-35.
Kurman RJ, Carcangiu ML, Herrington CS, et al. Chapter 5: tumours of the uterine corpus: mesenchymal tumors. In: WHO classification of tumours of female reproductive organs, 5th edition. Lyon, France: International Agency for Research on Cancer 2020.
孫克嘉、許越涵、劉家豪、邱垂青、邵芷萱、賴瓊如、莊其穆、王鵬惠。年輕女性的子宮內膜基質惡性肉瘤。婦癌醫學期刊:2019;49:35-39。

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