10例胎盘部位滋养层细胞肿瘤临床、病理免疫组化及超微结构研究

Placental Site Trophoblastic Tumor: Clinical, Histological, Immunocytochemical and Ultrastructural Studies oF 10 Cases

报告10例胎盘部位滋养层细胞肿瘤,平均年龄28.8岁,都有生育史。临床表现为阴道不规则流血或闭经。病理组织学特征为多边形或梭形胞浆丰富的瘤细胞弥漫或片状、索条状浸润于子宫肌纤维间。电镜下瘤细胞表面有少量微绒毛,瘤细胞间可见桥粒。免疫组化染色显示良性病例HPI强阳性,恶性病例HCG明显阳性。病人血HCG值明显升高,瘤细胞核分裂增多,HCG染色阳性增强似可作为提示生物学行为的参考。

Placental site trophoblastic tumor (PSTT) is an unique and interesting pathological entity with somewhat unpredictable behavior here 10 cases of the rare uterine tumors are reported with its clinical, histo logical, immunocytochemical and ultrastructural features. The clini cal presentations of the patients were irregular vaginal bleeding or amenorrhea and uterine enlargement with positive or negative pregnant tests.Histologically,the tumors were composed of large intermediate like cells which invaded the myometrium diffusely, in small clusters or in large sheets. The results of immunocytochemical study showed a strong positive HPL staining of tumor cells in the cases of PSTT with benigh behavior and a strong HCG staining of tumor cells in the cases with aggressive behavior. Thus, it seems that higher HCG value of pregnant test, high mitotic figures and strong HCG staining of the tumor cells might be correlated with a rather aggressive behavior. Also, the histological, ultrastructural and immunocytochemical features of our cases of PSTT support that PSTT originates from intermediate trophoblastic cells.