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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

27卷

期数:

2021年05期

页码:

511-514

栏目:

临床医学

出版日期:

2021-09-10

文章信息/Info

Title:

Clinicopathological analysis of 73 cases of yolk sac tumor

文章编号:

1006-8147(2021)05-0511-04

作者:

李广宁¹; 2; 曹文枫¹; 齐丽莎¹; 黄秋娟¹; 张文帅¹

（1.天津医科大学肿瘤医院病理科，国家肿瘤临床医学研究中心，天津市肿瘤重点防治实验室，天津市恶性肿瘤临床医学研究中心，天津 ³000⁶0；2.天津市北辰区中医医院病理科，天津³00⁴00）

Author(s):

LI Guang-ning¹; 2; CAO Wen-feng¹; QI Li-sha¹; HUANG Qiu-juan¹; ZHANG Wen-shuai¹

（1. Department of Pathology，Tianjin Medical University Cancer Institute and Hospital，National Clinical Research Center for Cancer，Tianjin Key Laboratory of Cancer Prevention and Therapy，Tianjin′s Clinical Research Center for Cancer，Tianjin 300060，China；2.

关键词:

生殖细胞肿瘤; 卵黄囊瘤; S-D小体; 免疫组化

Keywords:

germ cell tumors; yolk sac tumor; Schiller-Duvel body; immunohistochemical staining

分类号:

R737.31

DOI:

-

文献标志码:

A

摘要:

目的：总结卵黄囊瘤患者临床病理信息，探讨其病理学特征及临床鉴别依据。方法：收集2011年5月—2018年10月于天津医科大学肿瘤医院确诊的73例卵巢卵黄囊瘤患者，分析其临床病理信息；进行肿瘤标本切片HE染色；针对磷脂酰肌醇蛋白聚糖3（glypican-3）等行免疫组化染色；采用美国国立综合癌症网络（National Comprehensive Cancer Network，NCCN）发布的随访方法实行患者资料随访。结果：患者年龄分布为6个月～61岁；肿瘤直径1～28 cm；肿瘤多为囊实性，切面为筛孔与实性相间的多彩状；镜下可见网状微囊结构、透明小体与无定型的基底膜及黏液瘤样结构等不同的组织学形态；免疫组化结果显示，肿瘤细胞特异性表达glypican-3（93.8%）、甲胎蛋白（AFP，96.6%）、婆罗双树样基因4（SALL4，100%）、胎盘碱性磷酸酶（PLAP，86.5%）和抗广谱细胞角蛋白（CKpan，100%）；随访患者中8例复发，14例远处转移，2例死亡。统计发现Ki-67增殖指数≥50%的患者复发转移的风险是＜50%患者的5.091倍，男性患者复发/转移的风险较高，差异具有统计学意义（95%CI：4.09～6.67，P＜0.05）。结论：卵黄囊瘤临床病理分析中于性腺位置发病常见，其镜下病理学结构多样，可根据特征性结构及免疫组化染色进行鉴别诊断。

Abstract:

Objective: To summarize the clinicopathological information of patients with yolk sac tumor，explore its pathological characteristics and clinical identification basis. Methods: A total of 73 patients with ovarian yolk sac tumor diagnosed in Tianjin Medical University Cancer Hospital from May 2011 to October 2018 were collected，and their clinicopathological information was analyzed；HE staining of tumor specimen sections was performed；immunohistochemical staining for glypican-3（glypican-3） and others was developed；the follow-up method issued by the National Comprehensive Cancer Network（NCCN） was used to implement patient data follow-up. Results: The age distribution of the patients ranged from 6 months to 61 years old；the diameter of the tumors ranged from 1 cm to 28 cm；the tumors were mostly cystic and solid，and the section was colorful between the sieve hole and the reality；microscopically，different histological morphologies such as reticular microcapsule structure，hyaline bodies and amorphous basement membrane and myxoma-like structure could be detected；immunohistochemical results showed that tumor cells specifically expressed glypican-3（93.8%），alpha-fetoprotein（AFP，96.6%），spalt like transcription factor 4（SALL4，100%），placental alkaline phosphatase（PLAP，86.5%） and anti-broad spectrum cytokeratin（CKpan，100%）；8 patients relapsed during follow-up，14 patients had distant metastasis，and 2 patients died. It could be shown that the risk of recurrence and metastasis of patients with Ki-67 proliferation index ≥50% was 5.091 times as that of patients with <50%；the risk of recurrence/metastasis was higher in male patients，and the difference was statistically significant（95% CI： 4.09-6.67，P<0.05）.Conclusion: The incidence of yolk sac tumor is frequently associated with the incidence of gonads in clinicopathological analysis. It has a variety of microscopic pathological structures. The diagnosis can be made based on characteristic structures and immunohistochemical staining.

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相似文献/References:

[1]于秀杰 综述,申彦 审校.SALL4与生殖细胞肿瘤[J].天津医科大学学报,2017,23(03):283.

备注/Memo

备注/Memo:

基金项目 天津市卫计委重点攻关项目（16KG125）
作者简介 李广宁（1981-),硕士在读，研究方向：病理学与病理生理学；通信作者：曹文枫，E-mail：caowenfeng2017@163.com。

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更新日期/Last Update: 2021-09-01