关键词: 恶性中胚叶混合瘤, 临床病理, P53

Abstract: Objective To summarize the clinical and pathological characteristics and prognosis of malignant mesodermal mixed tumor（MMMT）in the female reproductive system,and analyze the relationship between P53 and mismatch repair proteins and the onset of MMMT. Methods A total of 15 cases diagnosed with MMMT after surgical resection at the First Affiliated Hospital of Dali University from September 2015 to September 2022 were collected．The clinical and pathological characteristics,immune phenotype（P53,mismatch repair protein,etc. ）,treatment plan were summarized．And the patients were followed-up. Results Ten of 15 cases of MMMT were primary in the uterus and 5 of 10 in the ovaries．The age range of onset was 49 to 76 years old,with an average age of 60 and a median age of 58．Clinical manifestations included vaginal bleeding or fluid discharge,with or without abdominal pain or pelvic masses．Under the microscope,all tumors were composed of malignant epithelial and mesenchymal tumors in different proportions,with 12 cases of P53 wild-type and 3 cases of mutant type．There were 4 cases of missing mismatch repair proteins（MSH6,MSH2,MLH1,PMS2）detected．Among the 15 patients,all underwent surgical treatment,and 12 underwent pelvic lymph node dissection with postoperative adjuvant chemotherapy and radiotherapy．Two cases were lost to follow-up,four cases died,six cases recurred,and three cases had no recurrence or metastasis after surgery. Conclusions MMMT are rare in clinical practice,with high malignancy and poor prognosis．Pathological diagnosis is difficult,and immunohistochemical staining is needed．The absence of P53 and mismatch repair protein is related to the occurrence of MMMT．Surgical resection is required for treatment,supplemented by radiotherapy and chemotherapy．

Key words: malignant mesodermal mixed tumors, clinicopathology, P53