八聚体结合转录因子4对卵巢原始生殖细胞肿瘤病理预后的诊断价值

Significance for diagnosis of ovarian primordial germ cell tumors by OCT4 and its correlation with pathological prognosis

目的探讨八聚体结合转录因子4(Oct4)对卵巢原始生殖细胞肿瘤病理预后的诊断价值。方法选取2016年8月至2018年8月间四川省梓潼县人民医院收治的40例卵巢无性细胞瘤患者作为观察组,另选取同期40例畸胎瘤患者和40例卵黄囊瘤患者分别作为对照A组和对照B组,采用免疫组化法检测Oct4在三组患者病理组织中的表达。比较Oct4在三组患者中的表达差异,分析Oct4表达与患者临床特点、病理分期及预后的相关性。结果观察组表达阳性26例,强阳性14例,阳性率为100. 0%,对照A组和对照B组均未检测到Oct4表达,阳性率为0. 0%,组间比较,差异有统计学意义(χ^2=76. 05,P <0. 05)。年龄≥20岁与<20岁的患者的Oct4表达,差异无统计学意义(P> 0. 94);肿瘤直径≥15cm与<15cm患者及腹水量≥100ml与<100ml患者的Oct4表达差异显著,差异均有统计学意义(均P <0. 02)。22例Ⅰ期患者中Oct4表达阳性21例,强阳性1例;18例Ⅱ~Ⅲ期患者中阳性5例,强阳性13例,Ⅰ期患者与Ⅱ~Ⅲ期患者比较,差异有统计学意义(χ^2=17. 07,P <0. 01)。Oct4表达阳性患者的5年总生存率为100. 0%,强阳性患者的5年总生存率为71. 4%,差异有统计学意义(χ^2=5. 38,P <0. 05)。结论 Oct4可以作为诊断和鉴别卵巢原始生殖细胞肿瘤的诊断依据,并可用于判断疾病预后。

Objective To explore significance for diagnosis of ovarian primordial germ cell tumors by octamer-binding transcription factor( OCT4) and its correlation with pathological prognosis. Methods Forty patients with asexual cell tumors admitted to Zitong County People’s Hospital from August 2016 to August 2018 were selected as the observation group. Another 40 cases with teratoma and 40 patients with yolk sac tumors were selected as control group A and control group B,respectively. The expression of OCT4 in pathological tissues was detected by immunohistochemistry. The differences in OCT4 expression in different pathological tissues,the correlation between OCT4 expression and clinical characteristics of patients,and the correlation between OCT4 expression and pathological stage and prognosis of patients were analyzed. Results Positive expression of OCT4 was found in 26 patients and strong positive expression was found in 14 patients and the positive rate was 100. 0% for the observation group. Positive expression of OCT4 was not found in the control group and the expression rate was 0. 0%( P < 0. 05). There was no significant difference between the patients ≥20 years of age and patients < 20 years of age( P > 0. 05). There was significant difference between patients with tumor size ≥15 cm and patients with tumor size < 15 cm and patients with≥ 100 ml fluid in the abdomen and patients with < 100 ml fluid in the abdomen( all P < 0. 05). Of 22 patients with stage Ⅰ ovarian primordial germ cell tumors,positive expression was found in 21 patients s and strong positive expression was found in 1 patient. Of 18 patients with stage Ⅱ~Ⅲ ovarian primordial germ cell tumors,positive expression was found in 5 patients and strong positive expression was found in 13 patients. There was significant difference between patients with stage Ⅰ and stage Ⅱ~Ⅲ ovarian primordial germ cell tumors( P < 0. 01). The 5-year overall survival rate was 100. 0% in patients with positive OCT4 expression and 71. 4% in patients with strong positive OCT4 expression( P < 0. 05). Conclusion OCT4 can be used as the basis of diagnosis and differential diagnosis of ovarian primordial germ cell tumors,and can be used to judge the prognosis of the disease.