CD10鉴别诊断子宫内膜间质肉瘤的系统评价

摘要

Objective:To investigate the clinical value of CD10 expression in differential diagnosis of endometrial stromal sarcoma ( ESS )by conducting a meta - analysis. Methods: Publications addressing CD10 expression in differential diagnosis of ESS were selected from CBM, Wanfang, VIP and CNKI databases. Results: According to inclusion criteria, sixteen case - control studies were retrieved with a total of 330 ESS patients, including 301 low - grade endometrial stromal sarcoma ( LGESS )patients and 29 high - grade endometrial stromal sarcoma ( HGESS )patients.Eta - analysis results showed that median CD10 expression positive ratio in ESS patients was 83. 2% , which was obviously higher than that negative patients ( OR = 11. 60,95% CI = 7. 80 - 17. 26,P ＜ 0. 001 ). Median CD10 expression positive ratio of LGESS and HGESS patients were 93. 5% and 58. 6% ,the former was significantly higher than the latter ( OR = 3.05,95%CI = 1.79 -5. 24,P =0.040 ). Conclusion: CD10 expression in ESS patients was closely correlated with prognosis. Median CD10 expression positive ratio of LGESS patients was higher than those with HGESS. CD10 plays an important role in differential diagnosis of ESS.%目的:探讨CD10鉴别诊断不同恶性程度子宫内膜间质肉瘤(endometrial stromal sarcoma,ESS)的临床价值.方法:计算机检索CBM、万方、维普及CNKI数据库,检索年限均从1998年1月到2011年2月.按Cochrane系统评价方法筛选研究、评价纳入研究的方法学质量、提取资料、分析数据.结果:最终16篇文献符合纳入标准,包括330例子宫内膜间质肉瘤患者,其中低度恶性子宫内膜间质肉瘤(low-grade endometrial stromal sarcoma,LGESS)患者301例,高度恶性子宫内膜间质肉瘤(high-grade endometrial stromal sarcoma,HGESS)患者29例.Meta分析结果表明,ESS患者中位CD10表达阳性高达83.2%,CD10表达阳性患者例数明显多于表达阴性者(OR=11.60,95%CI=7.80-17.26,P<0.001);LGESS和HGESS患者中位CD10表达阳性率分别为93.5%和58.6%,LGESS患者CD10表达阳性率显著高于HGESS 患者(OR=3.05,95%CI=1.79-5.24,P=0.040).结论:CD10表达水平与ESS恶性程度密切相关,LGESS患者CD10表达水平高于HGESS者,故CD10对于鉴别诊断不同恶性程度ESS具有重要临床价值.