骶尾部未成熟畸胎瘤神经组织分化与增殖的免疫组织化学研究

Differentiation and proliferation of immature sacrococcygeal teratoma

目的 了解骶尾部未成熟畸胎瘤神经组织分化与增殖的变化。方法 对 1 4例骶尾部未成熟畸胎瘤手术标本进行神经元特异性烯醇酶、神经纤维细丝蛋白、S1 0 0蛋白、波形蛋白、Ki 67及增殖细胞核抗原免疫组化染色 ,1 4例患儿收治年龄为 1d～ 4岁 ,平均 30 4 .8d ,其中男 6例 ,女 8例。术后多处切取瘤体组织置 1 0 %中性甲醛固定 2h ,常规石蜡包埋。石蜡切片、染色后行病理诊断并根据参考文献所列标准分级 ,其中Ⅰ级 6例 ,Ⅱ级 4例 ,Ⅲ级 4例。所有患儿术后均接受化疗并进行长期随访 ,随访内容有肿瘤有无复发、是否有远处转移、有无大便失禁等。笔者分析这些染色结果与病理分级间的关系。结果 神经元特异性烯醇酶与神经纤维细丝蛋白的表达随病理分级的提高阳性率下降 ,而波形蛋白、Ki 67及增殖细胞核抗原的表达随病理分级的提高阳性率上升 ,但S1 0 0的表达变化与病理分级无关。

Objective To understanding the properti es of differentiation and proliferation of neuronal tissue in immature sacrococcyg eal teratoma. Methods Specimens from 14 patients ( male 6, female 8) ag ed from 1 d to 4 years with immature sacrococcygeal teratoma were immunostained for neuron specific enolase, neurofilament, S 100 protein, vimentin, Ki-67 and proliferating cell nuclear antigen. The relationship between the changes of these antigens expression and the pathological grade was also analyzed. Results As the tumor became less differentiated, the expressions of neuron specific enolase and neurofilament were decreased, while t he expressions of vimentin, Ki-67 and proliferating cell nuclear antigen were i ncreased. The expression of S100, however, had no correlation with the grade of tumors.The follow-up results of all cases that received operation and chemother apy showed no relapse or metastasis with normal bowel bowel movements. Conclusion The immunohistochemical staining for markers o f neuronal tissue and cell proliferation might be useful in determining the diff erentiation of neuronal elements in immature sacrococcygeal teratoma.