中间型滋养细胞肿瘤的临床病理诊断分析

摘要

Objective Clinical study of intermediate trophoblastic tumor (i.e.: placental site trophoblastic tumor - PSTT and epithelioid trophoblastic tumor-ETT) of the pathological features and diagnostic analysis. Method The author selected 28 patients with malignant trophoblastic disease, make a comprehensive analysis of the clinical symptoms, pathological diagnosis and immunohistochemical results. Results In this group of patients showed irregular vaginal bleeding and abdominal pain symptoms and B-HCG were higher in patients with ETT;tumor cells in tissue necrosis and hyaline material and formed Island, map like shape, the main characteristics of PSTT patients for a single muscle fiber or several groups of muscle fiber separation, a funicular, massive arrangement;immune phenotype expression of epithelial, trophoblastic cell markers, but there are differences in the expression of M el-CAM, PLAP, HPL strength. Conclusion The intermediate trophoblastic tumor (IT) of PSTT, ETT is relatively rare, but they also have immunophenotypes and morphological characteristics of different, but in the biological behavior, clinical symptoms and inert is very similar, so we can through pathological analysis for auxiliary diagnosis or differential diagnosis.%目的临床研究中间型滋养细胞肿瘤（即：胎盘部位滋养叶细胞肿瘤-PSTT和上皮样滋养细胞肿瘤-ETT）的病理特征以及诊断分析。方法笔者将选取28例恶性滋养叶疾病患者，对患者的临床症状、病理诊断及免疫组织化学结果进行综合分析。结果本组患者均出现阴道不规则流血并伴有腹痛症状且B-HCG 较高；ETT患者的瘤细胞位于坏死组织及玻璃样物并形成岛屿状、地图样形状，PSTT患者的主要特点为单个平滑肌纤维或几组肌纤维分离，呈条索状、片块状排列；免疫表型表达上皮性、滋养细胞性标志物，但在M el-CAM、PLAP、HPL的强度表达方面存在差异性。结论在中间型滋养细胞肿瘤(IT)中PSTT、ETT是较为少见的，而二者又具有不同的免疫表型及形态学特征，但是在临床症状及惰性生物学行为上则极为相似，因此我们可通过病理学分析来进行辅助诊断或鉴别诊断。