卵黄囊瘤23例临床病理学分析

The clinicopathologic analysis of yolk sac tumor in 23 cases

目的探讨卵黄囊瘤(YST)的临床病理特征,以提高对该肿瘤的认识。方法选取我院2006年11月~2016年7月收治的经病理检查确诊为YST的患者23例作为研究对象,采用HE染色、免疫组化等方法研究其病理特征。结果 YST患者23例发生于睾丸9例,卵巢8例,性腺外6例。镜下观察肿瘤中见筛网状结构、由扁平上皮细胞排列成腺管样结构、含抗淀粉酶的过碘酸雪夫氏(PAS)阳性的透明小体、Schiller-Duval小体。免疫组化染色显示患者23例甲胎蛋白均(+),细胞角蛋白20例(+)、CD30(-),人绒毛膜促性腺激素7例(+),PLAP3例(+),AFPL灶性1例(+)。结论卵黄囊瘤临床比较少见,发生于性腺外更为罕见。临床表现无特异性,组织学特点、免疫组化、血清AFP水平对YST的诊断及鉴别诊断有重要意义。

Objective Explore the clinicopathological features of yolk sac tumor（YST）,in order to improve the understanding of the tumor.Selection,Methods From November 2006 to July 2006 were confirmed by pathological examination of 23 cases of YST patients as the research object, by adopting the method of HE staining and immunohistochemical study its pathological features.Results YST 23 cases occurred in patients with testicular 9 cases, 8 cases of ovarian, gonads 6 cases. The microscopic observation of tumor in see screen structure, by squamous epithelium cells arranged in the sample of the gland structure, include the amylase periodate snow＇s surname（PAS） positive transparent small body, Schiller-Duval small body. Immunohistochemical staining showed 23 cases of patients with AFP（＋）, cytokeratin 20 cases（＋）, CD30（-）, human chorionic gonadotropin（＋）, 7 cases PLAP3 cases（＋）, 1 AFPL focal（＋）.Conclusion Yolk sac tumor clinical rare, occurring in gonads is more rare. Lack of characteristic clinical manifestation, histological characteristics, immunohistochemical, serum AFP level for the diagnosis and differential diagnosis of YST has important significance.