胎盘部位滋养细胞肿瘤临床病理及免疫组化分析.docVIP

胎盘部位滋养细胞肿瘤临床病理及免疫组化分析 　 作者：张 杰，张雁军，高爱荣2，许俊龙，李玉红，任玉波 【关键词】 胎盘部位滋养细胞肿瘤；临床病理；免疫组化 　　［摘 要］ 目的：探讨胎盘部位滋养细胞肿瘤（PSTT）的临床病理及免疫组化特点。方法：收集8例PSTT患者的临床资料，并重新切片行组织学HE染色及SP法免疫组化染色，光镜观察。结果：PSTT是一种继发于妊娠后的妊娠相关疾病，常见症状为闭经及/或阴道流血，血清绒毛膜促性腺激素(HCG)可有轻～中度升高。光镜下瘤细胞为单一种植型的中间型滋养细胞，成片状、条索状浸润于肌纤维之间，血管浸润明显，但少有出血坏死及血管内瘤栓，分裂象少见。免疫组化示上皮膜抗原（EMA）、角蛋白（CK）、人胎盘泌乳素（HPL），中到强阳性表达。HCG仅1例弱阳性表达，肌动蛋白(Act)、波形蛋白(Vim)均阴性表达。结论：PSTT为少见的滋养细胞肿瘤，具有独特的光镜及免疫组化特点，这些特点可与其他滋养细胞疾病鉴别。 　　［关键词］ 胎盘部位滋养细胞肿瘤；临床病理；免疫组化 　　Clinicopathologic and Immunohistopathologic analyse of Placental Site Trophoblastic Tumor 　　Abstract：Objective To study the clinicopathologic features and immunohistochemical of placental site trophoblastic tumor(PSTT).Methods To collect 8 cases of PSTT and renew dyeing of HE and SP immunohistochemical stain,then studied by microscope.Results PSTT is a kind of desease which was correleative with pregency.Change of life and vigina bleeding were quite familiar and also Human chorionic gonadotropin(HCG)of blood serum rose lowly or moderately.Microscopically,tumor was consisted of onefold osculant trophoblastic cells and tomor cells invaded into peripheral muscularis sheetly or stripply with a little bleeding、necrosis and thrombus and seldomto watch karyomitosis,meanwhile tumor infiltrated blood vessel obviously.Immunohistochemical staining showed thattumor tissue expressed EMA、CK and HPL intensively,only one case expressed HCG faintly Act、Vim were expressed negatively.Conclusion A rare tropho blastic tumor,PSTT has its particular characteristics of microscope and immunohistochemistry and all these can differentiate it with other trophoblastic diseases. 　　Key words:PSTT(Placental site trophoblastic tumor );Clinicialpathoiogy;Immunohistochemistry 　　 　　胎盘部位滋养细胞肿瘤（PSTT）是一种罕见的滋养细胞肿瘤［1］,迄今为止文献报道仅见百余例［2］，故临床和病理医师对该肿瘤均缺乏足够的认识。本文收集8例PSTT，结合文献对其临床病理特点、免疫组化、诊断及鉴别诊断作一初步探讨，以便更好的掌握其特点。 　　1 材料和方法 　　1.1 材料 收集我院及市东昌医院1980年至2004年间经组织学确诊的PSTT共8例,其中6例为子宫全切标本，2例为刮宫标本，刮宫标本均深达肌层。 　　1.2 方法 所有病理均重新切片多张，取一张HE染色，由2位病理医师重新作组织学诊断，光镜观察其组织形态、细胞特征、核分