胎盘部位滋养细胞肿瘤13例临床病理分析

发布时间：2019-03-28 10:13

【摘要】：目的总结胎盘部位滋养细胞肿瘤(placental site trophoblastic tumor,PSTT)的临床病理特征。方法收集13例PSTT的临床病理学资料,采用免疫组织化学方法检测其中人绒毛膜促性腺激素(HCG)、胎盘生乳素(hPL)、CD146、CD10、广谱型细胞角蛋白(PCK)、细胞角蛋白18(CK18)、细胞角蛋白5/6(CK5/6)、P63、抑制素(α-inhibin)、Ki-67的表达情况,收集随访资料,总结PSTT的临床和病理特点。结果13例PSTT患者平均32岁。临床表现以继发性闭经和不规则阴道流血为主(分别为7例、3例)。11例患者前次妊娠为正常普通妊娠,1例为体外受精联合胚胎移植(IVF),1例为葡萄胎。6例患者手术切除子宫+化疗,3例患者行单纯子宫切除,3例患者因有生育要求保留子宫,仅行病灶切除术并辅以化疗,1例患者仅行清宫术。10例患者随访2~66个月,1例出现复发。13例患者均阳性表达hPL、CD146、PCK、CD10及CK18,11例患者阳性表达α-inhibin,5例患者弱阳性表达HCG,13例患者均不表达P63和CK5/6,Ki-67增殖指数平均19%。结论 PSTT多发生于生育期妇女,可继发于葡萄胎。其主要临床症状为异常阴道流血或继发性闭经。手术切除子宫是其主要治疗方式。
[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 (伪-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 伪-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.
【作者单位】：四川大学华西第二医院病理科出生缺陷与相关妇儿疾病教育部重点实验室;
【分类号】：R737.33

【相似文献】