Clinicopathological Characteristics And Expression Of CD10, CD117 In Malignant Mixed Mesodermal Tumor

Objictive:Malignant mixed mesodermal tumor (MMMT), also known as malignant mixed mullerian tumors of the uterus or uterine carcinosarcoma (UCs), is one of rare malignant tumors, highly aggressive, more used in clinical surgery and combined radiotherapy and chemotherapy in the treatment model, the lower its 5-year survival, median survival of less than 2 years, so as to improve the therapeutic and to raise awareness, this paper analyzes the clinicopathological characteristics, the expression of CD10,CD117,and the relationship between them and the prognosis of malignant mixed mesodermal tumor.Methods:Collected and observation 31 patients who diagnosed with malignant mixed mesodermal tumor received the initial surgical treatment in our Hospital between January,2005 and December 2009.The clinical data were reviewed including the age, menopause, clinical manifestations, laboratory examinations, extent of surgery, pathology, and adjuvant treatment.To analyze the relationship between clinicopathological characteristics and prognosis after complete pathological review. 31 cases have completed follew-up data.The median follow-up time was 24 months (range from 3 to 71 months). Immunohistochemistry were performed to detect the expression of CD10,CD117 in malignant mixed mesodermal tumor and analyze the relationship between the expression and the prognosis was analyzed.All statistical analyses were preformed using the SPSS software.The survival was computed using the Kaplan-Meier method with difference determined by log-rank test.Multivariate analyses were performed with the Cox stepwise regression model.Results:The average age of survival in patients with 56.32 years(19/31); 25 cases were post-menopausal, accounting for 80.6%(25/31);1 case had not been pregnant,3.2%(1/31);6 patients with hypertension or diabetes, accounting for 19.4%(6/31);3 cases with genetic family history accounting for 9.8%(3/31);11 patients with abnormal preoperative CA125,accounting for 35.5%(11/31);31 cases had routine lymph node dissection,of which 7 cases had lymph node metastasis, accounting for 22.6%(7/31);24 patients to adjuvant therapy, accounting for 77.4%(24/31);The 3-year overall survival(OS) of malignant mixed mesodermal tumor was 62.4%, The 5-year overall survival(OS) of malignant mixed mesodermal tumor was 37.7%, The average survival time was 69 months (median);The 3-year OS for pationts with FIGO stageⅠ,Ⅱ,ⅢandⅣwas 64.9%,100.0%,50.0%and 0; The 5-year OS for pationts with FIGO stageⅠ,Ⅱ,Ⅲand IV was 64.9%,100.0%,25.0% and 0;Homology of 18 patients, accounting for 58.1%(18/31); 13 cases heterologous, accounting for 41.9%(13/31);17 patients with superficial myometrial invasion, accounting for 54.8%(17/31);Deep myometrial invasion accounting for 45.2%(14/31); lymph-vascular space and neural invasion accounting for 41.9%(13/31);The positive expression rates of CD 10 protein for epithelial components and mesenchymal components were 25.8%and 87.1%;The expression (integrated score) of CD10 in epithelial and mesenchymal compents was not associated with the survival. The positive expression rates of CD117 protein for epithelial components and mesenchymal components were 22.6%and 54.8%; The expression (integrated score) of CD 117 in mesenchymal compents was related to prognosis(p≤0.05).In univariate analysis, preoperative CA125, surgical-pathological staging,lymph node involvement, the expression (integrated score) of CD117 in mesenchymal components were statistical significant, related to prognosis(p≤0.05), (P=0.050,0.018,0.000,and 0.000,respectively).In multivariate analysis, lymph node involvement and the expression (integrated score) of CD117 in mesenchymal components were independent prognostic factors of malignant mixed mesodermal tumor (P=0.000, P=0.000)Conclusion:The prognosis of malignant mixed mesodermal tumor may be related to, preoperative CA125,FIGO stage, lymph node involvement as well as the expression (integrated score) of CD117 in mesenchymal components.While, lymph node involvement and the expression (integrated score) of CD117 in mesenchymal components were independent prognostic factors of malignant mixed mesodermal tumor.Early diagnosis,content surgery,and the strengthened adjuvant therapy will improve the prognosis of patients.