CAJ | 학술논문

目的：探讨宫颈原发性恶性黑色素瘤的临床及病理特征。方法对2例宫颈原发性恶性黑色素瘤患者临床特征及组织标本苏木精-伊红（H E）染色和免疫组织化学染色检查结果进行回顾性分析。结果2例女性患者分别为46和58岁，均以阴道流血及宫颈肿块为主要症状，肿块呈息肉状和结节状伴糜烂、溃疡及出血。HE染色可见组织结构复杂，细胞类型多样，主要以上皮样或组织样细胞及梭形细胞主，可见散在的多核巨细胞；细胞异形性明显，可见核分裂象，黑色素颗粒可有可无。免疫组织化学染色显示 S-100蛋白、人黑色素瘤标记物45（HMB45）及波形蛋白（Vimentin）均呈阳性表达，平滑肌肌动蛋白（SMA）、白细胞共同抗原（LCA）、细胞角蛋白（CK）、上皮膜抗原（EMA）、结蛋白（Desmin）、神经元特异性烯醇化酶（NSE）、突触素（syn）均呈阴性表达。结论宫颈原发性恶性黑色素瘤极其罕见，恶性程度高，对放、化疗均不敏感，病死率高，预后差。普及宫颈恶性肿瘤筛查对该病的预防和治疗极为重要。
목적：탐토궁경원발성악성흑색소류적림상급병리특정。방법대2례궁경원발성악성흑색소류환자림상특정급조직표본소목정-이홍（H E）염색화면역조직화학염색검사결과진행회고성분석。결과2례녀성환자분별위46화58세，균이음도류혈급궁경종괴위주요증상，종괴정식육상화결절상반미란、궤양급출혈。HE염색가견조직결구복잡，세포류형다양，주요이상피양혹조직양세포급사형세포주，가견산재적다핵거세포；세포이형성명현，가견핵분렬상，흑색소과립가유가무。면역조직화학염색현시 S-100단백、인흑색소류표기물45（HMB45）급파형단백（Vimentin）균정양성표체，평활기기동단백（SMA）、백세포공동항원（LCA）、세포각단백（CK）、상피막항원（EMA）、결단백（Desmin）、신경원특이성희순화매（NSE）、돌촉소（syn）균정음성표체。결론궁경원발성악성흑색소류겁기한견，악성정도고，대방、화료균불민감，병사솔고，예후차。보급궁경악성종류사사대해병적예방화치료겁위중요。
Objective To explore the clinical and pathological features of primary malignant melanoma of cer-vix (PMMC).Methods Clinical characteristics and pathological detection results of hematine-eosin (HE)and immu-nohistochemistry stain were retrospectively analyzed in tow cases with PMMC.Results Two female patients at age of 46 and 58 years old presented with vaginal bleeding and polypoid mass with erosions,ulcers and bleeding.HE stain indicated that the lesions were composed of three cell types,including epithelial-like cells,spindle cells and polykaryo-cytes.The cellular atypia and mitotic were visible.Tumor cells showed positive for S-100 protein,human melanoma marker 45 (HMB45),vimentin,but negative for smooth muscle actin (SMA),leukocyte common antigen (LCA),cy-tokeratin (CK),epithelial membrane antigen (EMA),Desmin,neuron specific enolase (NSE)and synaptophysin (syn).Conclusion PMMC could be extremely rare,not sensitive to radiotherapy and chemotherapy,possess high mortality and poor prognosis.Cervical cancer screening should be advocated for the prevention and therapy of this disease.