儿童未成熟畸胎瘤与成熟畸胎瘤中神经上皮组织的生物学特点分析

Analysis of biological characters of the neuroepithelial tissue in children with immature and mature teratoma

目的对儿童未成熟畸胎瘤和成熟畸胎瘤内决定肿瘤分化程度的神经上皮组织进行多项免疫组化指标检测，分析肿瘤细胞的生物学特性。方法收集儿童畸胎瘤病理组织标本55例，根据病理诊断分为成熟畸胎瘤和未成熟畸胎瘤二组，提取肿瘤内神经上皮组织标本分别进行能反映肿瘤细胞增殖、凋亡、侵袭力和神经胶质细胞成熟度的Bax、Bcl-2、PCNA、Ki-67、CyclinE、p14^ARF／p16β、MMP-9和GFAP各指标分别进行免疫组化染色。结果未成熟畸胎瘤中的神经上皮组织CyclinE呈低表达，成熟畸胎瘤也呈低度表达；p14^ARF／p16β两组均为较高表达；PCNA在未成熟畸胎瘤呈较高表达，在成熟畸胎瘤中较低表达；Ki-67在未成熟畸胎瘤呈较低表达，在成熟畸胎瘤中表达程度较前者更低；Bcl-2在未成熟畸胎瘤呈中度表达，而在成熟畸胎瘤中为较低表达；Pax在二组均呈中度表达；MMP-9在二组均为较低表达；而GFAP在未成熟畸胎瘤为低表达，而在成熟畸胎瘤中则为高表达。结论儿童未成熟畸胎瘤中分化程度较低的神经上皮组织具有一定的增殖、分化、侵袭转移能力，但在良恶性指标方面仍接近成熟畸胎瘤的分子生物学特点，偏向良性或交界性肿瘤。GFAP可能是成熟与未成熟畸胎瘤的一种有效的鉴别指标。

Objective To analyze the biological characters of the tumor cells in children with immature and mature teratoma by immunohistochemistry staining. Methods Fifty-five teratoma speci- mens in children were collected and divided into mature and immature group, according to their pathological diagnosis. Neuroepithelial tissue of the tumors was extracted, and its multiple indexes were analyzed by the immunohistochemical method, including Pax, Bcl-2, PCNA, Ki-67, CyclinE, P14ARF/ P1613, MMP-9 and GFAP, which could represent the generation, apoptosis and invasive ability of tumor cells and the maturity of glial cells. Results Cyclin E had a low expression in neural tissue in both groups. P14ARF/P1613 had a relatively high expression in both groups. PCNA had a relatively high expression in immature teratoma, but relatively low in mature teratoma. Ki-67 had a relatively low expression in immature teratoma, and lower in mature teratoma. Bcl-2 had a moderate expression in immature teratoma, and low expression in mature teratoma. Pax had a moderate expression in both groups. MMP-9 had a relatively low expression in both groups. GFAP had a low expression in imma- ture teratoma, but high in mature teratoma. Conclusions The neuroepithelial tissue which has a low degree of differentiation in children＇s immature teratoma has a potential ability of proliferation, differentiation, invasion and metastasis. However, the immature teratoma still has the molecular biological characters approximate to that of mature teratoma, and is more close to benign or borderline tumors. GFAP can probably be an efficient marker to differentiate mature and immature teratoma.