卵黄囊瘤32例临床病理分析

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1、【摘要】0的：探讨卵黄囊瘤（yolksactumour,YST）的临床病理特征、免疫组化特点、诊断及鉴别诊断，以提高对YST的认识。方法：回顾性分析2008-2015年本院确诊的32例YST患者的临床病理特征及免疫组化染色结果，并复习相关文献，进行对比总结。结果：32例YST患者中男19例，女13例，年龄7个月〜50岁（平均12.6岁），肿瘤发生于睾丸17例，卵巢10例，性腺外5例。病理标本镜检可见到特征性的S-D小体，疏松网状结构，及细胞内外的透明小体。免疫表型可见32例Glypican-3、CK、SALL4均（+），CD30、hCG、CD117、

2、EMA、CD15、CK7、ER、PR均（-），28例AFP（+），20例vimentin（+），5例PLAP（灶+），2例OCT4（灶+），Ki-67增殖指数大于50%o结论：YST是一种少见的生殖细胞肿瘤，发生于性腺外时容易误诊，可依靠组织学特点及免疫组化结果进行明确诊断。【关键词】卵黄囊瘤；临床病理；鉴别诊断;免疫组织化学中图分类号R730.45文献标识码B文章编号1674-6805(2016)17-0048-03【Abstract】Objective:Toimprovethecognitionabouttheyolksactumor(YST)b

3、yexploringtheclinicopathologicalcharacteristics,immunohistochemicalcharacteristics,diagnosisanddifferentialdiagnosisofYST.Method：Thirty-twocasesofYSTwereselectedandtheclinicopathologicalcharacteristicsandimmunohistochemicalstainingwereretrospectiveanalyzed，andtherelevantliterat

4、urewerereviewedandcompared.Result：Amongthe32caseswithYST,19casesinmales,13casesinfemale，theaverageyearsoldwas12.6rangingfrom7monthsto50yearsold.Astotheoccurrencesite，17caseswerefoundintestis,10caseswerefoundinovaryand5caseswerefoundinextragonadalsites.Themicroscopicalresultshow

5、edcharacteristicSchiller-Duvalbodies,loosereticularstructureandhyalinedropletsinthetumortissue.TheimmunohistochemistryshowedGlypican-3，CKandSALL4wereexpressedinallofcases,whileCD30，hCG，CD117,EMA,CD15,CK7,ERandPRwerenotexpressedinallofthecases.TheexpressionofAFPwithdifferentleve

6、lswerefoundin28cases.Vimentinwereexpressedin20cases.ThespottyexpressionofPLAPwasshowedin5cases.ThespottyexpressionofOCT4wasshowedinonly2cases.TheproliferativeindexofKi-67wasmorethan50%.Conclusion：YSTisararegermcelltumor，whichiseasytobemisdiagnosedwhenappearedinextragonadalsites

7、.ThecorrectdiagnosisofYSTismainlydependedonhistopathologyandimmunohistochemicalstaining.【Keywords】Yolksactumor；Clinicalpathology；Differentialdiagnosis；ImmunohistochemistryFirst-author'saddress：ProvincialClinicalMedicalCollegeofFujianMedicalUniversity，Fuzhou350001，Chinadoi：10.14

8、033/j.cnki.cfmr.2016.17.025卵黄囊瘤(YST)又名内胚窦瘤，是一种起源于原始生殖细