β-HCG在颅内生殖细胞瘤临床-病理诊断中的价值  

Value of beta-HCG in clinicopathological diagnosis of intracranial germ cell tumors

作　　者：刘娟[1] 卢朝辉[1] LIU Juan;LU Zhao-hui(Department of Pathology, Beijing Union Medical College Hospital, Beijing 100750, China)

机构地区：[1]北京协和医院病理科,北京100005

出　　处：《诊断病理学杂志》2018年第6期420-424,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨颅内生殖细胞瘤的免疫表型、病理学特征与临床表现之间的关系。方法回顾性分析50例颅内生殖细胞瘤的组织学形态及免疫组化特征,对照患者临床表现、血清学及脑脊液检查结果进行统计学分析。结果 (1)50例中6例合并其他肿瘤成分(12%),其中4例合并滋养细胞成分,1例合并畸胎瘤伴恶性转化,1例合并成熟性畸胎瘤。此6例患者人绒毛膜促性腺激素(β-HCG)免疫组化染色均为强(+),脑脊液β-HCG值均≥5IU/l(8.4~439 IU/l,平均163.23±179.14 IU/l),血中β-HCG值4.5~798 IU/l,平均173.37±311.44 IU/l,≥5 IU/l者5例。(2)44例单纯性生殖细胞瘤中脑脊液β-HCG≥5 IU/l者33例(33/44,75%),血中β-HCG值≥5 IU/l者9例(9/44,20.45%),24例进行了β-HCG的免疫组织化学染色,阳性7例(7/24,29.17%)。组织学β-HCG阳性与术前血液β-HCG值差异显著(P>0.05),而与术前脑脊液β-HCG值差异不显著(P>0.05)。结论颅内生殖细胞瘤成份单纯者多见,合并成份亦多为β-HCG阳性的生殖细胞相关性肿瘤;脑脊液β-HCG≥5 IU/l具有较高的诊断敏感性,血液和组织中的β-HCG具有较高特异性。Objective To explore the relationship between immunophenotype, pathological features and clinical phenotype of intracranial germinoma. Methods The histological and immunohistochemical features of 50 cases of intracranial germ cell tumors were retrospectively analyzed. The clinical manifestations,serology and cerebrospinal fluid examination results were statistically analyzed. Results In 50 cases,6 cases were combined with other tumor components（ 12%）,including 4 cases with trophoblastic components,1 cases with teratomas with malignant transformation and 1 cases with mature teratoma,in which human chorionic gonadotropin（ beta-HCG） immunohistochemical staining was strongly positive（ positive rate 100%） in all the cases. CSF beta-HCG values were greater than 5 IU/l（ 8. 4 ~ 439 IU/l,average 163. 23 ＋ 179. 14 IU/l）,4. 5 ~ 798 IU/l beta-HCG value in the blood,an average of 173. 37 ＋ 311. 44 IU/l,more than 5 IU/l in 5 cases. beta-HCG in cerebrospinal fluid was greater than or equal to 5 IU/l in 33 of 44 cases of germ cell tumor（ 33/44,75%）; 9 cases of 5 IU/l beta value was more than HCG in the blood（ 9/44,20. 45%）; In 24 cases that were studied by immunohistochemical staining of beta-HCG,7 were positive（ 7/24,29. 17%）. There was a significant correlation between the histological beta-HCG positive and preoperative blood beta-HCG value（ P 〉 0. 01）,but no correlation with the preoperative cerebrospinal fluid beta-HCG value was noted（ P 〉 0. 05）. Conclusion Intracranial germ cell tumors present more commonly with simple component. If not single,the combination is commonly seen with germ cell tumor with positive beta-HCG; cerebrospinal fluid beta-HCG greater than 5 IU/l has the sensitivity in the diagnosis,while beta-HCG in both blood and tissue has higher specificity.

关 键 词：生殖细胞瘤 Β-HCG 颅内肿瘤 病理组织学类型 特异性 敏感性 

分 类 号：R739.41[医药卫生—肿瘤]