论文摘要：
Context: Dedifferentiated carcinoma (DC) is a uterine malignancy that contain both low- grade endometrioid carcinoma (LGEC) and undifferentiated carcinoma (UC). DC is an aggressive tumor even when the undifferentiated carcinoma component represents only 20% of the entire neoplasm. Until now, most publications about DC were individual case reports. Therefore, making in depth investigation on pathological features of DC is very important for accurate diagnosis and treatment. Design: In this paper, eleven cases of DC from Jan, 2011 to Dec, 2012 in Tianjin Central Hospital of Gynecology Obstetrics were selected. Then the pathological characteristics including tumor size, depth of myometrial ivasion, intravascular tumor emboli and immunophenotype were analyzed. In addition, microvessel density (MVD) in DC and high-grade endometrioid carcinoma (Grade III) was compared by CD105 immunostaining.
Results: We found the common pathological features in these cases were large sizes of the tumor (average sizes of the tumor is 65cm3), presence of the myometrial invasion (12/12) and focal squamous metaplasia. In all of the cases, intravascular tumor emboli (confirmed by CD31 immunostaining) were identified. Follow-up results (6-53 months) showed that one patient who was treated only with surgery without Adjuvant radiation and chemotherapy, died after 12 months of the initial operation. And one patient with lymph node metastasis had a relapse after 8 months of the operation. Moreover, the percentage of UC component was not related with the survival. In addition, CD105 were used to measure microvessel density (MVD). The result showed that MVD in DC was much more than that in high-grade endometrioid carcinoma (P = 0.003).
Conclusion: We believe that DC is a type of tumor more often associated with angiogenesis, which suggests that anti-neovascularization might be a potential strategy for the treatment of this kind of tumor. However, we failed to find the correlation between the percentage of UC component with survival of patient, which more confirmed that DC is a kind of aggressive endometrial carcinoma no matter how percentage of UC was included.
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