卵巢Sertoli-Leydig细胞瘤8例临床病理分析  

A Clinicopathological Analysis of Ovarian Sertoli-Leydig Cell Tumor

作　　者：金燕 印永祥 陈海霞 赵华 张琪 JIN Yan;YIN Yongxiang;CHEN Haixia;ZHAO Hua;ZHANG Qi(Pathology Department,Maternity Hospital Affiliated to Jiangnan University(Wuxi Woman andEnfants Care Hospital),Wuxi 214002,China)

机构地区：[1]江南大学附属妇产医院(无锡市妇幼保健院)病理科,江苏无锡214002

出　　处：《标记免疫分析与临床》2023年第9期1472-1475,共4页Labeled Immunoassays and Clinical Medicine

基　　金：无锡市太湖人才计划高层次人才培养项目(编号:BJ2020072)。

摘　　要：目的 探讨卵巢Sertoli-Leydig细胞瘤(Sertoli-Leydig cell tumour, SLCT)的临床病理学特征、诊断、鉴别诊断、治疗及预后。方法 收集8例SLCT标本,观察大体及镜下特征,分析临床病理特点,行免疫组化方法检查,并复习相关文献。结果 8例患者平均发病年龄42.8岁,肿瘤均为单侧发生,右侧多见,多为实性或囊实性,可分泌雄激素,中-低分化者多见,病变局限于卵巢。免疫组化α-抑制素(α-inhibin)、广谱细胞角蛋白(CK-pan)、波形蛋白(Vimentin)、钙结合蛋白(Calretinin)、细胞表面糖蛋白99(CD99)、细胞表面金属肽链内切酶(CD10)、翼状螺旋/叉头转录因子2(FOXL2)、雌激素受体(ER)、雄激素受体(AR)均有较高阳性表达,细胞增殖标记(Ki-67)一般呈低表达,上皮细胞膜抗原(EMA)、甲胎蛋白(AFP)、嗜铬素A(CgA)、突触素(SYN)均为阴性,网染可见网状纤维围绕Sertoli细胞巢周围分布,AR在所有肿瘤中呈阳性表达,Sertoli细胞强于Leydig细胞。结论 SLCT发病率低,形态复杂,临床易误诊,确诊有赖于病理诊断和免疫组织化学染色,血清学雄激素的升高及免疫组化雄激素的表达对于诊断该肿瘤有一定指导意义,肿瘤的临床分期是评判肿瘤预后最有意义的指标,治疗采用以手术为主的综合措施。Objective To investigate the clinicopathological features,diagnosis,differential diagnosis,treatment and prognosis of ovarian Sertoli-Leydig cell tumour(SLCT).Methods Eight cases of SLCTs specimens were collected for the study.The general and microscopic features were observed,the clinicopathological features were analyzed,immunohistochemical methods were performed,and the relevant literature was reviewed.Results The average age of the 8 patients was 42.75 years old.Patients’tumors were unilateral,mostly on the right side,solid or cystic,and could secrete androgens.The lesions were mainly in the ovary.Moderate to low differentiations were more common,and the lesions were limited to the ovary.Immunohistochemical staining showed thatα-inhibin,CK-pan,Vimentin,Calretinin,CD99,CD10,FOXL2,ER and AR were highly expressed,while Ki-67 was generally low expressed.EMA,AFP,CgA and SYN were all negative,and reticular fibers were distributed around the Sertoli cell nest.AR was positively expressed in all tumors,with Sertoli cells being stronger than Leydig cells.Conclusion SCLT has low incidence rate,with complex morphology,and is easy to be mis-diagnosed clinically.The diagnosis accuracy depends on pathological diagnosis and immunohistochemical staining.The increase of serum androgen and the expression of immunohistochemical androgen have certain guiding significance for the diagnosis of the tumor.The clinical stage of the tumor is the most significant indicator for judging the prognosis.The corresponding treatment is mainly surgery.

关 键 词：卵巢肿瘤 Sertoli-Leydig细胞瘤 临床病理特征 免疫组织化学 

分 类 号：R737.31[医药卫生—肿瘤]