[目的]探讨横纹肌肉瘤的临床病理学、免疫组化及分子遗传学特征。[方法]回顾性研究22例横纹肌肉瘤(RMS)患者的病历资料、病理形态学特点、免疫组化以及分子遗传学特征。[结果]本组男15例,女7例;年龄2~60岁,中位年龄35岁。肿瘤8例发生于骨盆与躯干;发生于四肢6例;其他部位6例。组织学上:10例为腺泡性横纹肌肉瘤;11例为多形性横纹肌肉瘤;1例表现为胚胎性横纹肌肉瘤形态。免疫组化标记显示:所有病例均不同程度的表达Vimentin(17/17,100%)和Desmin(22/22,100%);大部分病例表达Myogenin(19/22,86.3%)和MyoD1(15/17,88.2%),少部分病例表达CD99(5/17,29.4%)及CK(3/17,17.6%),17例横纹肌肉瘤LCA均为阴性(0/17,0%),Ki-67平均阳性指数为43%。FISH结果显示:10例腺泡性横纹肌肉瘤均检测到FKHR基因分离;11例多形性横纹肌肉瘤及1例胚胎性横纹肌肉瘤均未检测到FKHR基因分离信号。[结论]组织学结合免疫组化及FKHR基因FISH检测对横纹肌肉瘤的诊断及分型具有重要意义。
[Objective] To investigate the clinicopathological,immunohistochemical,and molecular genetic characteristics of rhabdomyosarcoma. [Methods] Twenty-two cases of rhabdomyosarcoma were reviewed to determine their clinicopathological,morphological,immunohistochemical,and molecular genetic features. [Results] The patient cohort comprised 15 male and 7 female patients,aged 2 to 60 years( median: 35 years). Of the 22 tumors,8 were in the pelvis and trunk,6 were in the extremities,and 6 were in other sites. Histologically,10 tumors were alveolar rhabdomyosarcomas,11 were pleomorphic rhabdomyosarcomas,and 1 was an embryonic rhabdomyosarcoma. On immunohistochemistry,all tumor cells were diffusely positive for vimentin( 17 /17,100%) and desmin( 22 /22,100%),whereas the tumors showed variable expression of myogenin( 19 /22,86. 3%),myoD1( 15 /17,88. 2%),CD99( 5 /17,29. 4%),and cytokeratin( 3 /17,17. 6%). Leucocyte common antigen expression was negative in all 17 cases analyzed( 0 /17,0%). The average Ki-67 index was 43%. Fluorescence in situ hybridization( FISH) results revealed the FKHR gene rearrangement in 10 cases of alveolar rhabdomyosarcoma,whereas 11 cases of pleomorphic rhabdomyosarcoma and 1 case of embryonic rhabdomyosarcoma were negative for the FKHR gene rearrangement.[Conclusion] Histological examination combined with immunohistochemistry and FISH play an important role in the differential diagnosis of rhabdomyosarcoma.