中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2012年
11期
752-755
,共4页
田保玲%高霭峰%徐灿%常筱颖%徐振群%苏庆华%杨向红
田保玲%高靄峰%徐燦%常篠穎%徐振群%囌慶華%楊嚮紅
전보령%고애봉%서찬%상소영%서진군%소경화%양향홍
睾丸肿瘤%精原细胞瘤%诊断,鉴别
睪汍腫瘤%精原細胞瘤%診斷,鑒彆
고환종류%정원세포류%진단,감별
Testicular neoplasms%Seminoma%Diagnosis,differential
目的 探讨精母细胞型精原细胞瘤的临床病理特征及生物学行为.方法 收集中国医科大学附属盛京医院病理科2003年1月至2011年5月间病理诊断为睾丸精原细胞瘤68例,精母细胞型精原细胞瘤3例.分析患者临床资料,进行HE及免疫组织化学SP法染色,并对患者进行随访.结果 经复查,确认66例为睾丸精原细胞瘤,5例为精母细胞型精原细胞瘤.这5例患者年龄平均53岁,均为临床Ⅰ期,无隐睾史,不伴其他生殖细胞肿瘤,免疫组织化学示CK、波形蛋白、OCT3/4、胎盘碱性磷酸酶(PLAP)等均阴性,PAS糖原染色亦阴性;1例示CD117散在阴性,其余4例CD117阴性.术后11个月至6年无1例复发或转移.66例睾丸精原细胞瘤患者平均年龄37岁,约12%伴隐睾,约11%是临床Ⅱ期.免疫组织化学表现为PLAP和OCT3/4全部阳性,69.6%(32/46)CD117阳性.随访时间 1至9年,随访的28例Ⅰ期患者中,有2例复发,1例死亡,Ⅱ期3例患者中1例死亡.结论 精母细胞型精原细胞瘤不同于精原细胞瘤,是一少见的、独特的有低转移潜能的临床病理类型,由于它很少发生转移或肉瘤样分化,并具有良好的预后,在睾丸切除术后,可不需进一步处理,为避免过度治疗,正确的组织学诊断非常重要.
目的 探討精母細胞型精原細胞瘤的臨床病理特徵及生物學行為.方法 收集中國醫科大學附屬盛京醫院病理科2003年1月至2011年5月間病理診斷為睪汍精原細胞瘤68例,精母細胞型精原細胞瘤3例.分析患者臨床資料,進行HE及免疫組織化學SP法染色,併對患者進行隨訪.結果 經複查,確認66例為睪汍精原細胞瘤,5例為精母細胞型精原細胞瘤.這5例患者年齡平均53歲,均為臨床Ⅰ期,無隱睪史,不伴其他生殖細胞腫瘤,免疫組織化學示CK、波形蛋白、OCT3/4、胎盤堿性燐痠酶(PLAP)等均陰性,PAS糖原染色亦陰性;1例示CD117散在陰性,其餘4例CD117陰性.術後11箇月至6年無1例複髮或轉移.66例睪汍精原細胞瘤患者平均年齡37歲,約12%伴隱睪,約11%是臨床Ⅱ期.免疫組織化學錶現為PLAP和OCT3/4全部暘性,69.6%(32/46)CD117暘性.隨訪時間 1至9年,隨訪的28例Ⅰ期患者中,有2例複髮,1例死亡,Ⅱ期3例患者中1例死亡.結論 精母細胞型精原細胞瘤不同于精原細胞瘤,是一少見的、獨特的有低轉移潛能的臨床病理類型,由于它很少髮生轉移或肉瘤樣分化,併具有良好的預後,在睪汍切除術後,可不需進一步處理,為避免過度治療,正確的組織學診斷非常重要.
목적 탐토정모세포형정원세포류적림상병리특정급생물학행위.방법 수집중국의과대학부속성경의원병이과2003년1월지2011년5월간병리진단위고환정원세포류68례,정모세포형정원세포류3례.분석환자림상자료,진행HE급면역조직화학SP법염색,병대환자진행수방.결과 경복사,학인66례위고환정원세포류,5례위정모세포형정원세포류.저5례환자년령평균53세,균위림상Ⅰ기,무은고사,불반기타생식세포종류,면역조직화학시CK、파형단백、OCT3/4、태반감성린산매(PLAP)등균음성,PAS당원염색역음성;1례시CD117산재음성,기여4례CD117음성.술후11개월지6년무1례복발혹전이.66례고환정원세포류환자평균년령37세,약12%반은고,약11%시림상Ⅱ기.면역조직화학표현위PLAP화OCT3/4전부양성,69.6%(32/46)CD117양성.수방시간 1지9년,수방적28례Ⅰ기환자중,유2례복발,1례사망,Ⅱ기3례환자중1례사망.결론 정모세포형정원세포류불동우정원세포류,시일소견적、독특적유저전이잠능적림상병리류형,유우타흔소발생전이혹육류양분화,병구유량호적예후,재고환절제술후,가불수진일보처리,위피면과도치료,정학적조직학진단비상중요.
Objective To study the cinicopathologic features and biological behavior of spermatocytic seminoma.Methods A retrospective analysis of patients diagnosed as seminoma,spermatocytic seminoma between January 2003 and May 2011,was performed.Clinical data,HE stained section and immunohistochemical staining (SP method) were reviewed with follow-up.Results Sixty-six cases of seminoma and 5 cases of spermatocytic seminoma were identified.The average age at the diagnosis of 5 cases of spermatocytic seminoma was 53 years,and no patient had a history of crytorchidism or germ cell tumor.All five patients had stage pT1 tumor.Immunohistochemical studies showed that spermatocytic seminoma was negative for CK,vimentin,OCT3/4,PLAP,and LCA,and PAS staining was also negative.All five patients were well after operation.In contrast,the average age at diagnosis of the 66 cases of seminoma was 37 years,in which 12% had a history of crytorchidism and 11% were in stage pT2 or the above.Immunohistochemical studies showed that seminoma was positive for OCT3/4,PLAP,and CD117.During the follow-up,2 patients developed metastasis and 3 patients died of the disease.Conclusions Spermatocytic seminoma is rare and appears to follow a benign clinical course Due to its favourable prognosis,further treatment is not necessary after orchidectomy.Accurate pathologic diagnosis is critical for patient management and for avoiding over-treatment.