卵黄囊瘤16例临床病理学分析

The clinicopathologic analysis of yolk sac tumor in 16 cases

目的:探讨卵黄囊瘤(YST)临床病理特征、免疫组织化学(免疫组化)染色及鉴别诊断要点,为YST临床诊断和治疗提供参考依据。方法:选择经手术和病理检查确诊为YST的患者16例,采用HE染色、免疫组化等方法研究其病理特征。结果:16例患者YST发生于睾丸4例,卵巢6例,性腺外6例。镜下肿瘤细胞排列成疏松网状结构,S-D小体,肿瘤细胞细胞质内外有透明小体。免疫组化染色显示16例甲胎蛋白、细胞角蛋白均阳性,8例人胎盘碱性磷酸酶、白细胞表面抗原CD99阳性,1例癌胚抗原局灶阳性,12例过碘酸雪夫染色阳性,所有患者人绒毛膜促性腺激素均阴性。结论:YST临床较为少见,发生于性腺外更为罕见。临床表现无特征性而与其发生部位有关,组织学特点、免疫组化及甲胎蛋白对于YST诊断和鉴别诊断具有重要意义。

Objective：To investigate the clinicopathologic characteristics,immunohistochemistry staining and differential diagnosis of yolk sac tumor（ YST） for providing the reference in the clinical diagnosis and treatment of YST. Methods：The pathologic characteristics in 16 YST cases diagnosed by operation and pathology were analyzed using HE staining and immunohistochemical technique. Results：Among 16 cases with YST,4 cases in testis,6 cases in ovary and 6 cases in extragonadal sites were found. Microscopically,the tumor cells arranging in loose reticular structure,Schiller-Duval bodies and hyaline droplets in the tumor tissue were detected. The positive expressions of cytokeratin and fetoprotein,human placental alkaline phosphatase and CD99,carcino-embryonic antigen and periodic ocid schiff in 16,8,1 and 12 cases were detected using immunohistochemistry,respectively. The expression of β-HCG in all cases were negative. Conclusions：YST is a rare disease, especially for happening in extragonadal sites. The clinical symptom of YST is not specific. The occurrence site,pathological features,immunohistochemistry and serum alpha-fetoprotein have important significance in the diagnosis and differential diagnosis of YST.