OCT4、CD117、CD30在生殖细胞肿瘤中的表达及鉴别诊断意义  

Expression and diagnostic significance of OCT4, CD117 and CD30 in germ cell tumors

作　　者：滕梁红[1] 卢德宏[1] 徐庆中[1] 付永娟[1] 杨虹[1] 贺志立[1] 

机构地区：[1]首都医科大学宣武医院病理科,北京100053

出　　处：《中华病理学杂志》2005年第11期711-715,共5页Chinese Journal of Pathology

摘　　要：目的研究OCT4、CD117、CD30在不同生殖细胞肿瘤类型中的表达,及其在鉴别诊断中的应用价值。方法应用免疫组织化学技术EnVision法检测OCT4在63例生殖细胞肿瘤的表达情况,包括21例睾丸精原细胞瘤,7例卵巢无性细胞瘤,8例中枢神经系统生殖细胞瘤,8例胚胎性癌,6例卵黄囊瘤,10例成熟性畸胎瘤,3例未成熟性畸胎瘤。25例非生殖细胞肿瘤的表达情况作为对照,包括8例颗粒细胞瘤,4例透明细胞癌,5例间质细胞瘤,4例弥漫性大B细胞淋巴瘤,4例恶性黑色素瘤中的表达情况,同时检测CD117和CD30在所有生殖细胞肿瘤中的表达情况。结果OCT4在100%的精原细胞瘤(21/21)、8/8的生殖细胞瘤、6/7的无性细胞瘤,以及7/8的胚胎性癌中阳性表达,定位于细胞核;仅在1例卵黄囊瘤和1例透明细胞癌中有弱阳性表达,其余生殖细胞肿瘤及非生殖细胞肿瘤中均为阴性。CD117在90.5%(19/21)的精原细胞瘤、7/8的生殖细胞瘤以及5/7的无性细胞瘤中阳性表达,主要定位于胞膜;1例卵黄囊瘤的部分区域胞膜弱表达,在畸胎瘤中鳞状上皮基底层的黑色素细胞阳性表达,所有胚胎性癌中均是阴性。CD30在6/8的胚胎性癌中表达阳性,定位于细胞膜;只有1例生殖细胞瘤有弱的阳性表达,主要定位于胞质,其余精原细胞瘤、生殖细胞瘤、无性细胞瘤中均是阴性表达;另外在1例卵黄囊瘤中有局灶的胞质内阳性表达,在畸胎瘤中均是阴性。结论OCT4是标记精原细胞瘤、生殖细胞瘤、无性细胞瘤和胚胎性癌的一种特异而敏感的指标;联合应用OCT4、CD117和CD30对于诊断和鉴别诊断精原细胞瘤、生殖细胞瘤、无性细胞瘤和胚胎性癌具有较高的应用价值。Objective To study the immunohistochemical expression of OCT4, CD117 and CD30 in germ cell tumors and to assess their diagnostic value. Methods lmmunohistoehemieal study for OCT4 was performed on formalin-fixed, paraffin-embedded tissues of 63 cases of germ cell tumors, including seminoma （21）, dysgerminoma （7）, germinoma （ 8）, embryonal carcinoma （ 8）, yolk sac tumor （6）, mature teratoma （10） and immature teratoma （3）, as well as 25 eases of non-germ cell tumors, including granulosa cell tumor （8）, clear cell adenocareinoma （4）, Leydig＇s cell tumor （5）, diffuse large B-cell lymphoma （4） and malignant melanoma （4）. Besides, the expression of CD117 and CD30 in all germ cell tumors was studied. Results All cases of seminoma and germinoma, 6/7 eases of dysgerminoma and 7/8 cases of embryonal carcinoma were positive for OCT4, with strong nuclear staining. All other germ cell tumors and non-germ cell tumors were negative for OCT4, except for 1 case of yolk sac tumor and 1 case of clear cell adenocarcinoma which showed weak staining. Positive membranous expression of CD117 was demonstrated in 19/：21 （90. 5% ） seminoma, 5/7 dysgerminoma and 7/8 germinoma. Focal weak membranous staining was also noted in 1 case of yolk sac tumor. The melanocytes in teratoma were also positive for CD117. All cases of embryonal carcinoma were negative. On the other hand, positive membranous expression of CD30 were demonstrated in 6/8 embryonal carcinoma. One case of germinoma and 1 case of yolk sac tumor showed weak cytoplasmic positivity. All cases of seminoma and dysgerminoma, 7/8 germinoma and all cases of teratoma were negative for CD30. Conclusions OCT4 is a sensitive and relatively specific marker for diagnosing seminoma, dysgerminoma, germinoma and embryonal carcinoma. CD117 and CD30 immunostains, when used in combination, represent valuable tools for distinguishing embryonal carcinoma and seminoma, dysgerminoma, germinoma.

关 键 词：肿瘤 生殖细胞和胚胎性 精原细胞瘤 无性细胞瘤 诊断 鉴别 

分 类 号：R730.4[医药卫生—肿瘤]