CAJ | 학술논문

目的：分析小儿卵黄囊瘤的临床特点，探讨脂肪酸合酶（Fatty acid synthase，FASN）在小儿卵黄囊瘤中的表达及意义。方法回顾性分析26例卵黄囊瘤患儿临床资料，运用免疫组化检测26例卵黄囊瘤、17例未成熟畸胎瘤、1例胚胎性癌及12例相关部位正常组织标本中 FASN 的表达情况。结果26例小儿卵黄囊瘤发病平均年龄2岁5个月，16例单纯以肿块就诊，5例单纯以局部继发症状就诊，5例同时具有肿块及局部症状。FASN 在卵黄囊瘤的表达程度（73％）显著高于未成熟畸胎瘤（28％）、胚胎性癌（0％）、正常组织（16％）。FASN 在性腺内和性腺外小儿卵黄囊瘤的阳性表达率分别为56％和100％。伴淋巴结或远处转移组和无转移组阳性表达率分别为100％和61％。FASN 的阳性表达率与临床分期呈正相关。以上差别均有统计学意义。化疗前后 FASN 表达率分别为72％和75％，差别无统计学意义。结论小儿卵黄囊瘤起病隐匿，进展迅速，手术治疗联合化疗有效，FASN 的表达可为诊治提供参考。
목적：분석소인란황낭류적림상특점，탐토지방산합매（Fatty acid synthase，FASN）재소인란황낭류중적표체급의의。방법회고성분석26례란황낭류환인림상자료，운용면역조화검측26례란황낭류、17례미성숙기태류、1례배태성암급12례상관부위정상조직표본중 FASN 적표체정황。결과26례소인란황낭류발병평균년령2세5개월，16례단순이종괴취진，5례단순이국부계발증상취진，5례동시구유종괴급국부증상。FASN 재란황낭류적표체정도（73％）현저고우미성숙기태류（28％）、배태성암（0％）、정상조직（16％）。FASN 재성선내화성선외소인란황낭류적양성표체솔분별위56％화100％。반림파결혹원처전이조화무전이조양성표체솔분별위100％화61％。FASN 적양성표체솔여림상분기정정상관。이상차별균유통계학의의。화료전후 FASN 표체솔분별위72％화75％，차별무통계학의의。결론소인란황낭류기병은닉，진전신속，수술치료연합화료유효，FASN 적표체가위진치제공삼고。
Objetive To analyse the clinical characteristics and the expression and significance of FASN in infant yolk sac tumor. Methods 26 clinical datas of pediatric yolk sac tumors were analyzed.These 26 yolk sac tumors and another 1 7 immature teratomas,1 embryonal carcinoma,1 2 associated normal tissues were studied with immunohistochemical detection. Results The average age of these yolk sac tumors was 2 years and 5 months old.The chief complaint of 1 6 cases was mass.Meanwhile 5 cases were simply of local symptoms and 5 cases showed both mass and local symptoms.Positive expression rate of FASN was 73% in yolk sac tumors,28% in immature teratomas,none in embryonal carcinoma and 1 6% in normal tissues.Expression of FASN was higher in extragonadal yolk sac tumor in children(1 00%)than in gonadal ones(56%).Positive ex-pression rate was 1 00% in the group of lymphaden or distant metastasis,while 61 % in the group of no metasta-sis.The expression rate of FASN in yolk sac tumor were positively correlated with clinical stages .There was no significant difference between yolk sac tumors without chemotherapy and ones with chemotherapy. Conclu-sions Yolk sac tumor has an early onset and is concealed,which is treated with surgery combined with chemo-therapy.The expression of FASN may provide a reference for the diagnosis and treatment of infant yolk sac tumor.