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 参见附件。

  [摘要] 通过对1例伴绒毛膜上皮癌分化的子宫内膜未分化癌进行临床、病理及免疫组化观察，结果发现，肿物大小约3.0 cm×2.5 cm，实性，质较硬，镜下肿瘤组织由分化差的上皮样细胞构成，癌细胞核大、异型，实性分布，间质少，可见多核合体细胞，核分裂多见。免疫组化显示瘤细胞CK7(+)、ER(-)、PR(-)、CD68(-)，合体细胞HCG(+)。这是一种罕见的恶性肿瘤，一般预后较差，由于文献报道例数有限，预后的评价尚待进一步统计分析。

 [关键词] 子宫内膜癌；未分化癌；免疫组化

 [中图分类号] R737.33 [文献标识码] B [文章编号] 1673-7210(2012)04(a)-0125-02

 Clinicopathological analysis of 1 case of endometrioid undifferentiated carcinoma with choriocacinomatous differentiation

 XU Yitong1 ZHANG Guanyu2▲ SU Yukun2

 1.Department of 94th Period Clinical, China Medical University, Liaoning Province, Shenyang 110001, China; 2.Department of Pathology, Liaoyang Petrochemical General Hospital, Liaoning Province, Liaoyang 111003, China

 [Abstract] One case of endometrioid undifferentiated carcinoma with choriocacinomatous differentiation was observed clinically and pathologically with HE staining and immunohistochemistry. The results showed that, the endometrial neoplasia was about 3.0 cm×2.5 cm. The low-differentiated tumor cells were arranged in solid nets with scant stroma, marked atypically, multinucleated syncytial cells and convoluted nuclei. The tumor cells stained positively for CK7(+), syncytial cells negatively for ER(-), PR(-), CD68(-) positively for HCG(+). Endometrioid undifferentiated carcinoma with choriocacinomatous differentiation is a rare entity with features of higher m alignant tumor, and the prognosis is difficult to be evaluated for rare cases reported.

 [Key words] Endometrioid carcinoma; Undifferentiated; Immunohistochemistry

 伴绒毛膜上皮癌分化的子宫内膜未分化癌(简称伴绒癌分化的子宫内膜未分化癌，endometrioid undifferentiated carcinoma with choriocacinomatous differentiation)是一种罕见的子宫内膜恶性肿瘤，国内外文献少有报道，现就我院诊断的1例伴绒癌分化的子宫内膜未分化癌患者，结合文献对其临床病理特点、诊断及鉴别诊断进行研究分析。

 1 资料与方法

 1.1 一般资料

 患者63岁，绝经12年，阴道不规则流血20余天，量少，无腹痛、无发热，门诊行诊刮，病理显示为“子宫内膜样腺癌”，于2008年12月收住院。入院时一般情况：体温36.4℃，心率76次/min，呼吸频率18次/min，血压130/80 mm Hg(1 mm Hg=0.133 kPa)。血清肿瘤相关标志物：CA125Ⅱ 9.4 U/mL，AFP 3.90 U/mL，CEA 1.50 U/mL，CA19-9 14.51 U/mL，ThCG 102.3 mU/mL。彩超检查：子宫后倾位，大小约6.5 cm×4.0 cm×2.8 cm，形态正常 ......