卵巢混合性生殖细胞肿瘤12例临床病理分析

Clinicopathological analysis of 12 case of ovarian mixed germ cell tumor

目的探讨原发卵巢混合性生殖细胞肿瘤(MGCT)的临床病理特点及鉴别诊断。方法回顾性分析12例原发性卵巢MGCT患者的临床病理资料,对其临床表现、预后、组织形态和免疫组化结果进行分析。结果卵巢MGCT占我院同期卵巢生殖细胞肿瘤的12.2%(12/98),卵巢MGCT可由多种生殖细胞肿瘤成分组成,镜下形态多样,肿瘤成分包括无性细胞瘤、卵黄囊瘤、畸胎瘤、胚胎性癌、绒毛膜癌。其中9例(75%)包含2种不同的生殖细胞肿瘤成分,2例(16.7%)包含3种不同的肿瘤成分,1例(8.3%)包含4种不同的肿瘤成分。结论卵巢MGCT非常少见,肿瘤的生物学行为、临床治疗和预后的不同与其所含成分相关,准确的病理诊断非常必要,免疫组化标记对病理诊断与鉴别诊断具有重要作用。

Objective To investigate the clinicopathological characteristics and differential diagnosis of primary ovarian mixed germ cell tumors.Methods The clinicopathological data of 12cases of ovarian mixed germ cell tumors were retrospectively analyzed with a review of the literature.Results MGCT accounted for 12.2%(12/98)of all the ovarian germ cell tumors diagnosed in our hospital.Morphologically, ovarian MGCT displayed a variety of subtypes:dysgerminoma in 9cases(75.0%),yolk sac tumor in 8(66.7%),teratoma in 6(50.0%),embryonal carcinoma in 4(33.3%)and choriocarcinoma in 1(8.3%). Nine of the cases(75%)were composed of two different germ cell elements,2(16.7%)composed of three, and 1(8.3%)composed of four.Conclusion Ovarian MGCT is rare.Its biological behavior,clinical management and prognosis vary with its different histological elements.Therefore,accurate pathological diagnosis is necessary.Immunohistochemistry plays an important role in the diagnosis and differential diagnosis of ovarian MGCT.