發(fā)布時(shí)間：2019-03-28 10:13

【摘要】：目的總結(jié)胎盤部位滋養(yǎng)細(xì)胞腫瘤(placental site trophoblastic tumor,PSTT)的臨床病理特征。方法收集13例PSTT的臨床病理學(xué)資料,采用免疫組織化學(xué)方法檢測(cè)其中人絨毛膜促性腺激素(HCG)、胎盤生乳素(hPL)、CD146、CD10、廣譜型細(xì)胞角蛋白(PCK)、細(xì)胞角蛋白18(CK18)、細(xì)胞角蛋白5/6(CK5/6)、P63、抑制素(α-inhibin)、Ki-67的表達(dá)情況,收集隨訪資料,總結(jié)PSTT的臨床和病理特點(diǎn)。結(jié)果13例PSTT患者平均32歲。臨床表現(xiàn)以繼發(fā)性閉經(jīng)和不規(guī)則陰道流血為主(分別為7例、3例)。11例患者前次妊娠為正常普通妊娠,1例為體外受精聯(lián)合胚胎移植(IVF),1例為葡萄胎。6例患者手術(shù)切除子宮+化療,3例患者行單純子宮切除,3例患者因有生育要求保留子宮,僅行病灶切除術(shù)并輔以化療,1例患者僅行清宮術(shù)。10例患者隨訪2~66個(gè)月,1例出現(xiàn)復(fù)發(fā)。13例患者均陽性表達(dá)hPL、CD146、PCK、CD10及CK18,11例患者陽性表達(dá)α-inhibin,5例患者弱陽性表達(dá)HCG,13例患者均不表達(dá)P63和CK5/6,Ki-67增殖指數(shù)平均19%。結(jié)論 PSTT多發(fā)生于生育期婦女,可繼發(fā)于葡萄胎。其主要臨床癥狀為異常陰道流血或繼發(fā)性閉經(jīng)。手術(shù)切除子宮是其主要治療方式。
[Abstract]:Objective to summarize the clinicopathological features of placental trophoblastic tumor (placental site trophoblastic tumor,PSTT). Methods the clinicopathological data of 13 cases of PSTT were collected and the human chorionic gonadotropin (HCG), placental prolactin (hPL), CD146,CD10, broad spectrum cytokeratin (PCK), was detected by immunohistochemical method. The expressions of cytokeratin 18 (CK18), cytokeratin 5 (CK5/6), P63 and inhibin (偽-inhibin), Ki-67) were analyzed. The clinical and pathological features of PSTT were summarized. Results the average age of 13 patients with PSTT was 32 years. The main clinical manifestations were secondary amenorrhea and irregular vaginal bleeding (7 cases, 3 cases, respectively). 11 cases of previous pregnancy were normal pregnancy and 1 case of in vitro fertilization combined with embryo transfer (IVF),). One case was hydatidiform mole. 6 cases underwent hysterectomy and chemotherapy, 3 cases underwent simple hysterectomy, 3 cases retained uterus due to fertility requirements, only focus resection and chemotherapy were performed. One patient only underwent uterine debridement. 10 patients were followed up for 2 months for 66 months, one patient recurred, 13 patients were all positive for hPL,CD146,PCK,CD10 and CK18,11 patients were positive for 偽-inhibin,5, and one patient was weakly positive for HCG,. The mean expression of P63 and CK5/6,Ki-67 proliferation index was 19% in 13 patients. Conclusion most of PSTT occur in reproductive women and may be secondary to hydatidiform mole. The main clinical symptoms are abnormal vaginal bleeding or secondary amenorrhea. Surgical hysterectomy is the main treatment.
【作者單位】： 四川大學(xué)華西第二醫(yī)院病理科出生缺陷與相關(guān)婦兒疾病教育部重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R737.33

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