METHODS: The retrospective study was conducted on 30 cases of gravid hysterectomy with histopathologic diagnosis of PAS. To identify the depth of EVT, immunohistochemical stainings were performed using anti MNF116 (cytokeratins 5, 6, 8, 17, 19), actin-SM, HPL (Human Placental Lactogen), vimentin and GATA3 antibodies.
RESULTS: Our cases were graded based on the degree of invasion of the myometrium. Ten were grade 1 (33.3%), 12 grade 2 (40%) and 8 grade 3A (26.7%). EVT invasion was best seen and evident by double immunostainings with actin-SM and cytokeratins, actin-SM and HPL, actin-SM and GATA3.
CONCLUSIONS: The role of pathologist is decisive to determine the different grades of PAS. A better understanding of the depth of myometrial invasion can be achieved by the use of immunohistochemistry affording an important tool to obtain reproducible grading of PAS. This purpose is crucial in the setting of postoperative quality reviews and particularly in the forensic medicine field.
方法:对30例经组织病理学诊断为PAS的妊娠子宫切除术进行回顾性研究。为了确定EVT的深度,使用抗MNF116(细胞角蛋白5、6、8、17、19)进行免疫组织化学染色,肌动蛋白-SM,HPL(人胎盘催乳素),波形蛋白和GATA3抗体。
结果:我们的病例根据子宫肌层的浸润程度进行分级。十个是一年级(33.3%),12级2(40%)和8级3A(26.7%)。通过肌动蛋白-SM和细胞角蛋白的双重免疫染色,可以最好地看到和明显的EVT侵袭,肌动蛋白-SM和HPL,肌动蛋白-SM和GATA3。
结论:病理学家的作用对于确定PAS的不同等级是决定性的。通过使用免疫组织化学可以更好地了解子宫肌层浸润的深度,这为获得可重复的PAS分级提供了重要的工具。此目的对于术后质量审查的设置至关重要,尤其是在法医学领域。