卵巢多胚瘤的病理形态学和免疫组织化学研究

Histopathological and Immunohistochemical study of ovarian polyembryoma

对１例罕见的卵巢恶性生殖细胞肿瘤中的多胚瘤瘤组织进行病理形态学观察，并且采用免疫组化的方法进行研究。结果：光镜下观察到大量各种形态的胚胎样体，在胚胎样体周围见胚胎性肝样组织、滋养叶细胞等多种成分。免疫组化标记结果：（１）甲胎蛋白（ＡＦＰ）不仅在胚胎样体中的卵黄囊细胞、内胚层细胞和外胚层细胞缘呈阳性，而且在粘液基质中的多种成分均呈阳性；（２）肝样组织不仅对ＡＦＰ和α＿１－抗胰蛋白酶（ＡＡＴ）呈阳性反应，而且对人绒毛膜促性腺激素（ｈＣＧ）也呈阳性反应；（３）应用ｈＣＧ和人胎盘催乳素（ｈＰＬ）标记，证实肿瘤的滋养叶细胞中，不仅有合体细胞，而且存在中间型细胞和细胞滋养叶细胞。

case of polyembryoma which is rare in ovarian malignant germ cell tumors was reported.Micro-scopically,numerous and variable embryoid bodies,surrounded by embryonic hepatoid tissues,tro-phoblastic cells and multiple elements, were observed.The results of immunohistochemical analysis were:(1) alpha fetoprotein(AFP)was not only shown positive in yolk sac cells among the embryoid bOdies,in the endederm and in the margins of the ectodermal cells,but also in multiple elements in the mucinous matrix.(2) Hepatoid tissues reacted positively to AFP and alpha antitrypsin(AAT) as well as to hCG. (3)By using hCG and human placental lactogen(hPL)as markers it is proven that among trophoblastic cells of the tumor, not only syncytiotrophoblastic cells but also the intermediate cells and the cytotrophoblastic cells could be identified.