睾丸精原细胞瘤临床病理特征与免疫表型分析

Morphological characteristics and immunohistochemical analysis of seminoma testis

目的探讨睾丸精原细胞瘤临床病理特点及免疫表型,进而判断其生物学行为及患者预后情况。方法应用HE及免疫组织化学SP法对(2012年10月-2016年5月)安徽省立医院已确诊的43例精原细胞瘤的病理形态进行分析总结。结果经查阅,确诊43例精原细胞瘤包括3种类型,经典型精原细胞瘤37例、精母细胞型精原细胞瘤4例、间变型精原细胞瘤2例。(1)经典型精原细胞瘤肿瘤细胞主要呈片状、小巢状、条索状、微囊状生长,间质纤维血管分割,淋巴样细胞浸润,可见不同程度的肉芽肿性反应;PLAP+,CD117+,CK-,D2-40+,CD30-,AFP-,HCG-,CD34-,抑制素-;(2)精母细胞型精原细胞瘤无明显的肉芽肿性反应,淋巴细胞浸润罕见;PLAP-,CD117少数+,CK-,D2-40-,CD30-,AFP-,HCG-,CD34-,抑制素-;(3)间变型精原细胞瘤可见出血、坏死,瘤细胞异型明显,核分裂像多见。PLAP+,CD117少数+,CK-,D2-40+,CD30-,AFP-,HCG-,CD34-,抑制素-。结论不同病理类型的精原细胞瘤的组织学结构和免疫表型各具有特征性,正确的分型对于临床治疗及判断预后有一定的指导作用。

Objective To study clinical pathological features and immune phenotype of seminoma testis which would help to assess the tumorous biological behavior and prognosis. Methods Using HE and immunohistochemical techniques(SP)(October2012-May 2016), 43 cases of primary cell tumor in Anhui Provincial Hospital were analyzed and summarized. Results Diagnosis of43 cases of primary cell tumors included three types, 37 cases of classic type of precision of the original, 4 Spermatocyte seminoma, 2cases of variant seminoma cell tumor. Tumor cells of the classical seminoma mainly demonstrate platelike, small nests, funicular, micro cystic growing; which are segmented by fiber vascular, the infiltracion of lymphoid cell in the interstitial tissue. The classical seminoma has different levels of visible granulomatous reaction and a large number of lymphocyte infiltracion, PLAP+, CD117+, CK-, D2-40+,CD30-, AFP-, HCG-, CD34-, inhibin-; Spermatocyte seminoma has no obvious granulomatous reaction and rare lymphocyte infiltracion. PLAP-, CD117(a few cells+), CK-, D2-40-, CD30-, AFP-, HCG-, CD34-, inhibin-; the cells of variant seminoma with hemorrhage and necrosis are markedly atypical, and karyokinesis is increased. PLAP+, CD117(a few cells+), CK-, D2-40+, CD30-,AFP-, HCG-, CD34-, inhibin-. Conclusions Different pathological types of seminoma testis have their individual histological structure and the immune phenotype. Correct classification is helpful for clinical treatment and prognosis.