性腺外恶性生殖细胞肿瘤37例临床病理分析

目的 探讨性腺外恶性生殖细胞肿瘤的病理类型和临床特点。方法 根据WHO肿瘤国际组织学分类(第 2版 )对 37例性腺外恶性生殖细胞肿瘤重新评价 ,部分病例做相应免疫组化染色 ,并将肿瘤的组织类型和临床特点与性腺恶性生殖细胞肿瘤进行比较分析。结果 患者年龄 1 5～ 5 8岁 ,中位年龄 2 4岁。男性 2 8人 ,女性 9人 ,男女之比为 3 1∶1。发生于纵隔 2 8例 ,腹膜后 5例 ,前列腺、骶尾部、鞍区、阴道各 1例。列前三位的肿瘤分别是卵黄囊瘤、畸胎瘤 (未成熟畸胎瘤、PNET和畸胎瘤恶变 )和精原细胞瘤 ,另有 5例为混合型生殖细胞瘤。结论 性腺外恶性生殖细胞肿瘤相对少见 ,预后差 ,发病率与年龄、性别关系密切 ,好发部位为纵隔和腹膜后 ,卵黄囊瘤最为多见。

性腺外生殖细胞瘤1例报告并文献复习

目的:提高对性腺外生殖细胞瘤诊治的认识。方法:报道我院收治的1例性腺外生殖细胞肿瘤患者的诊治情况,并结合文献反思。结果:患者初步诊断为腹膜后肿瘤,行腹膜后肿瘤切除术,因瘤体大手术困难,术中连同左肾切除,并发胰腺损伤。术后病理诊断为:恶性生殖细胞肿瘤。术后行睾丸查体,发现左侧睾丸占位,并追查AFP、HCG、LDH阴性,二期行左侧睾丸切除术,病理左睾丸精原细胞瘤。术后予PEB方案化疗7周期,随访8年无肿瘤复发转移,患者术后8年未育。结论:对有隐睾病史并位于中轴线肿瘤的患者,需特别重视睾丸查体,睾丸超声检查及AFP等指标的检查,鉴别肿瘤是否为性腺肿瘤转移,如是可考虑先行放化疗,减少手术并发症,实现精准诊疗。

卵巢恶性非性腺母细胞型生殖细胞-性索-间质肿瘤

目的 :探讨卵巢恶性非性腺母细胞型生殖细胞 性索 间质肿瘤的临床病理学特点。方法 :对 1例卵巢恶性非性腺母细胞型生殖细胞 性索 间质肿瘤进行光镜、组织化学和免疫组化染色。结果 :(1 )光镜观察 :瘤细胞呈巢状或蜂窝状分布 ,个别区域有囊性滤泡状结构。瘤细胞主要向生殖细胞、间质细胞和粒层细胞分化 ,并以生殖细胞分化占优势。 (2 )组织化学染色 :向生殖细胞分化的部分细胞PAS染色阳性。 (3)免疫组化染色 :绒毛膜促性腺激素 (hCG)、细胞角蛋白 (CK)合体滋养细胞阳性 ;波形蛋白 (vimentin)间质细胞、粒层细胞阳性 ;孕激素受体 (PR)、神经元特异性烯醇化酶 (NSE)以及c erbB 2、bcl 2部分生殖细胞及间质细胞阳性 ;甲胎蛋白 (AFP)少数生殖细胞阳性 ;白细胞共同抗原 (LCA)、胶质纤维酸性蛋白 (GFAP)、雌激素受体(ER)、转移抑制因子 (nm2 3)、癌胚抗原 (CEA)、平滑肌肌动蛋白 (SMA)均阴性。结论 :非性腺母细胞型生殖细胞 性索 间质肿瘤 ,组织学起源尚未明了 ,组织学形态须与性腺母细胞瘤、两性母细胞瘤、无性细胞瘤、性索 间质肿瘤及非特殊类型类固醇细胞瘤相鉴别。

性腺外生殖细胞肿瘤的诊治现状和进展

性腺外生殖细胞肿瘤约占所有生殖细胞肿瘤的2%～5%,好发于人体中线部位,尤其多见于纵膈、腹膜后区及松果体等部位,其中纵膈生殖细胞肿瘤占所有性腺外生殖细胞肿瘤的50%～70%。由于该肿瘤临床表现、组织类型、发病部位的多样性,其诊断、治疗策略及预后不同于与生殖腺原发生殖细胞肿瘤,因此,本文将综述性腺外生殖细胞肿瘤的临床表现、诊断、治疗及预后相关因素,以期为临床治疗与研究提供参考。

汽车尾气的生殖毒性及对微量元素的影响

目的了解使用无铅化汽油后汽车尾气的生殖毒性效应。方法30只SD大鼠等分为实验和对照组,根据染毒时间4、6和8周不等各分为3个亚组,对照组用空白吸收液灌胃,实验组用汽车尾气吸收液灌胃,每周5 d,每天1次,灌胃量0.1 ml/L。观察大鼠生殖毒性及睾丸组织微量元素的变化。结果尾气吸收液染毒大鼠体重变化不明显;睾丸、附睾的脏器系数低于同时相对照组(P<0.05),且随时间呈下降趋势;精子含量和存活率显著降低,而畸形率增高(P<0.05);睾丸中Zn、Mn代谢紊乱,出现Zn低、Mn高,有时间-效应关系。结论汽车尾气具有明显的生殖毒性,微量元素代谢紊乱对生殖腺的损害起了重要作用。

烹调油烟对雄性大鼠的生殖毒性研究

染毒组大鼠采用半自动式吸入烹调油烟 (COF) [浓度 (4 3± 4)mg/m3 ] ,阴性对照组吸入加热空气 (2 4～ 2 8℃ ) ,每组雄性SD大鼠 15只 ,于染毒 2 0d、40d、60d观察COF对大鼠生殖腺毒性及其微量元素的影响。在吸入COF 40d、60d时大鼠体重均有降低趋势 ;睾丸、附睾脏器系数低于对照组 (P <0 0 5 ) ,且呈时间 效应关系 ;精子含量和存活率显著降低 ,畸形率明显升高 ,且死精子多 ;睾丸中Zn、Mn代谢紊乱 ,出现Zn降低、Mn升高 ,并呈时间 效应关系。上述结果说明烹调油烟对生殖腺具有明显毒性 ,同时提示微量元素代谢紊乱可能对生殖腺的损害起了重要作用。

27例性腺外生殖细胞肿瘤的超声诊断与病理对照分析

本文探讨性腺外生殖细胞肿瘤的超声图像与病理组织类型的关系,为临床诊断、选择治疗方案提供准确信息。结果显示,超声检查结果按病理学组织类型分为畸胎瘤、卵黄囊瘤、精原细胞瘤、胚胎癌等,好发部位为腹膜后与纵隔。表明超声对于性腺外生殖细胞肿瘤有较高的临床诊断价值。

Reproductive Cycle and Seasonal Variations in Lipid Content and Fatty Acid Composition in Gonad of the Cockle Fulvia mutica in Relation to Temperature and Food

From March 2004 to February 2005,seasonal variations in lipid content and fatty acid composition of gonad of the cockle Fulvia mutica(Reeve) were studied on the eastern coast of China in relation to the reproductive cycle and environment conditions(e.g.,temperature and food availability).Histological analysis as well as lipid and fatty acid analyses were performed on neutral and polar lipids of the gonad.Results showed that gametogenesis occurred in winter and spring at the expense of lipids previously accumulated in summer and autumn,whereas spawning occurred in summer(20.4-24.6℃).The seasonal variation in lipid content was similar to that of the mean oocyte diameter.In both neutral and polar lipids,the 20:5n-3 and 22:6n-3 levels were relatively higher than saturated fatty acids,and polyunsaturated fatty acids were abundant,with series n-3 as the predominant component.Seasonal variations in the 20:5n-3 and 22:6n-3 levels and the principal n-3 fatty acids were clearly related to the reproductive cycle.The ∑(n-3) and ∑(n-6) values were relatively high during January-May,and the associated unsaturation index was significantly higher than that in other months.The results suggest that fatty acids play an important role in the gametogenesis of F.mutica.

Treatment of hypogonadotropic male hypogonadism: Case-based scenarios

The aim of this study is to review four case-based scenarios regarding the treatment of symptomatic hypogonadism in men. The article is designed as a review of published literature. We conducted a PubMed literature search for the time period of 1989-2014, concentrating on 26 studies investigating the effcacy of various therapeutic options on semen analysis, pregnancy outcomes, time to recovery of spermatogenesis, as well as serum and intratesticular testosterone levels. Our results demonstrated thatexogenous testosterone suppresses intratesticular testosterone production, which is an absolute prerequisite for normal spermatogenesis. Cessation of exogenous testosterone should be recommended for men desiring to maintain their fertility. Therapies that protect the testis involve human chorionic gonadotropin （hCG） therapy or selective estrogen receptor modulators （SERMs）, but may also include low dose hCG with exogenous testosterone. Off-label use of SERMs, such as clomiphene citrate, are effective for maintaining testosterone production long-term and offer the convenience of representing a safe, oral therapy. At present, routine use of aromatase inhibitors is not recommended based on a lack of long-term data. We concluded that exogenous testosterone supplementation decreases sperm production. It was determined that clomiphene citrate is a safe and effective therapy for men who desire to maintain fertility. Although less frequently used in the general population, hCG therapy with or without testosterone supplementation represents an alternative treatment.

腹膜后肿瘤的病理诊断与鉴别诊断

腹膜后肿瘤泛指原发于腹膜后脏器的肿瘤性病变。转移性癌和淋巴造血系统肿瘤通常不属于腹膜后肿瘤范畴,但可发生于腹膜后,并容易在临床上和病理上造成误诊。根据组织学类型,腹膜后肿瘤大致分为软组织肿瘤、副交感神经系统性肿瘤、神经外胚层肿瘤、性腺外生殖细胞瘤和淋巴造血系统肿瘤[1]。在对腹膜后肿瘤治疗前,明确病理诊断至关重要。但腹膜后肿瘤由于其部位的特殊性,常需经皮穿刺活检,给病理诊断带来很大挑战。临床病理医师应熟悉腹膜后肿瘤的临床病理学特点,合理采用辅助检测手段(包括免疫组织化学和分子检测),为临床治疗提供具有重要参考信息的病理诊断。

Dietary vitamin A,ascorbic acid and α-tocopherol affect the gonad development and reproductive performance of starry flounder Platichthys stellatus broodstock

The present trial was conducted with starry flounder Platichthys stellatus broodstock to evaluate the effects of dietary vitamin A, ascorbic acid, and a-tocopherol on the gonadal development and reproductive performance. 8 000 IU/kg diet vitaminA （VA group）, 500 mg/kg diet ascorbic acid （Vcpp group）, or 250 mg/kg diet a-tocopherol （a-TA group） was added into basal diet to create 3 vitamin experimental diets, respectively. Each diet was fed to 450 starry flounder broodstock for 104 days. Samples were collected weekly. The gonadosomatic index （GSI） of 3 vitamin experimental groups first decreased and then increased. Maximum GSI of Vcpp group was higher than that of ct-TA group but lower than that of VA group. The spawning periods of 3 vitamin experimental groups lasted 49, 56, and 45 days, respectively. No mature eggs were observed in the control group during the trial. The absolute fecundity （AF） and relative fecundity （RF） of a-TA group was higher than that of Vcpp group but lower than that of VA group. The results suggest that different vitamins play different roles in the fish reproductive process. Vitamin A stimulated the maturation of the ovary, ascorbic acid prolonged the spawning period, and a-tocopherol affected the development of the eggs.

Description of the biology of Caspian vimba,Vimba vimba(Linnaeus,1758),in Gorgan Bay-Miankaleh Wildlife Refuge(southeast Caspian Sea)

We collected Vimba vimba throughout the spawning season （mid April to mid June, 2007） in Gorgan Bay （south-western Iran） and investigated its age, growth, and reproductive traits. The maximum age was 5＋ years. Both sexes grew allometrically （positive for males： b=3.140 9 and negative for females： b=2.791 4）. The von Bertalanffy growth functions were described by the formulae Lf=32.565（1-e-0.184（t＋0.530）） for males and Lt=35.950（1-e-0.179（t＋0.529）） for females. The overall sex ratio was balanced, but males were predominant in the smaller size classes and females in the larger size classes. Based on the gonadosomatic index （GSI） values, spawning appears to occur between late April and late May in the bay. The highest mean GSI was 6.44 for males in early May and 20.36 for females in late April Absolute fecundity varies from the minimum of 5 436 eggs for age 3＋ fish to the maximum of 36 141 eggs for age 5＋ fish. Fecundity was also positively correlated with fish size （length and weight）. Egg diameter ranged from 1.05 to 1.70 nun in the mean of 1.42 mm. There was no correlation between female size and ova diameter.

Effect of temperature and photoperiod on maturation of Cephalothrix hongkongiensis(Nemertea: Palaeonemertea)

The limited knowledge about the relationships between environmental factors and the maturation and reproductive seasonality of nemerteans is mostly obtained from field studies, and in many cases is conjectural. Few species have been studied under well-controlled laboratory conditions. In this work, the effects of temperature and photoperiod on gonad development and spawning of Cephalothrix hongkongiensis were observed by rearing worms under different temperatures and photoperiods. Worms reared at 4~C and 6~C showed no growth or gonadal development, and all died within 109 days. At 8~C and 12~C, gonads could be seen from 90 days to the termination of the 360-day experiment, but no spawning was observed. Worms maintained at 16, 24, and 28~C showed both gonadal development and spawning, and matured faster at higher temperatures. Under a fixed temperature （16℃）, photoperiod did not have any significant impact on maturation and spawning. It is likely that temperature plays a major role in regulating the maturation and reproductive cycle of C. hongkongiensis.

罕见46,XX性发育睾丸疾病合并前列腺生殖细胞肿瘤病例的遗传学及病理学特征分析

目的分析一例46,XX性发育睾丸疾病合并前列腺生殖细胞肿瘤患者的临床特点、遗传学和病理学特征并探讨其致病原因。方法对患者进行临床特征分析及病理学检查,用染色体核型分析及荧光原位杂交技术分析其遗传学特征。结果患者身高偏矮、双侧睾丸小、乳房轻度增大,血清甲胎蛋白浓度显著升高,卵泡刺激素、促黄体生成素、泌乳素升高,睾酮水平偏低。染色体核型为46,XX,荧光原位杂交提示一条X染色体短臂末端上存在SRY基因。病理学诊断为前列腺原发性生殖细胞肿瘤,主要为卵黄囊瘤。结论确诊一例46,XX性发育睾丸疾病合并原发前列腺生殖细胞肿瘤病例,丰富了该疾病的基因和表型谱,并为该病治疗提供一些思路。