子宫颈、子宫内膜发生的腺癌，有必要先对其来源进行鉴别；对发生在子宫内膜的腺癌，还要进一步区分为1型和2型。上述鉴别诊断是有一定临床意义的。本文侧重对联合使用常见的几种免疫组化染色辅助诊断宫内膜两种类型的腺癌进行了研究报道。

文献出处：

Arch Pathol Lab Med. 2013 Nov;137(11):1574-83. doi: 10.5858/arpa.2012-0445-OA.

Histologic and immunohistochemical analyses of endometrial carcinomas: experiences from endometrial biopsies in 358 consultation cases.

Wei JJ, Paintal A, Keh P.

Source

From the Department of Pathology, Feinberg Medical School, Northwestern University, Chicago, Illinois.

Abstract

Context.-Uterine serous carcinoma is biologically more aggressive than the endometrioid carcinoma. Because uterine serous carcinoma has a high propensity for lymphovascular invasion and intraperitoneal and extra-abdominal spread, accurate diagnosis of this tumor type in endometrial biopsies/curettings is critical for appropriate clinical management. Objective.-To share our experience in the evaluation of endometrial biopsy specimens in type I and type II endometrial adenocarcinoma. Design.-We retrospectively reviewed 358 biopsies containing endometrial carcinoma during a recent 3 year period of our consultation records. In cases in which our interpretation differed from the submitting diagnosis, a panel of immunostains was performed. The performance characteristics of each antibody in our panel was calculated in this group of challenging cases. Results.-Among the endometrial carcinomas we examined, a diagnosis of type I carcinoma accounted for 91% of cases (327 of 358) and type II carcinoma for 9% of cases (31 of 358); 41 cases (11.5%) were ambiguous or discordant (differing from submitted diagnoses and reviewed) based on histology alone. All 41 ambiguous and discordant cases were further evaluated with a battery of immunohistochemical markers. Of the 41 cases, 36 (88%) were ultimately classified (10 cases [24%] were endometrioid carcinoma; 18 cases [44%] were uterine serous carcinoma; 8 cases [20%] resulted in various other outcomes) and 5 cases (12%) remained indeterminate. Conclusions.-Making the distinction between type I and II endometrial carcinoma remains a common problem in general practice. Although no one biomarker provides excellent statistical performance, a panel of immunohistochemical markers is often useful in difficult cases.

下面的图片参考自诊断免疫组织化学第二版。