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目的:探讨胎盘部位滋养细胞肿瘤(PSTT)的临床病理及免疫组化特点。方法:收集8例PSTT患者的临床资料,并重新切片行组织学HE染色及SP法免疫组化染色,光镜观察。结果:PSTT是一种继发于妊娠后的妊娠相关疾病,常见症状为闭经及/或阴道流血,血清绒毛膜促性腺激素(HCG)可有轻～中度升高。光镜下瘤细胞为单一种植型的中间型滋养细胞,成片状、条索状浸润于肌纤维之间,血管浸润明显,但少有出血坏死及血管内瘤栓,分裂象少见。免疫组化示上皮膜抗原(EMA)、角蛋白(CK)、人胎盘泌乳素(HPL),中到强阳性表达。HCG仅1例弱阳性表达,肌动蛋白(Act)、波形蛋白(Vim)均阴性表达。结论:PSTT为少见的滋养细胞肿瘤,具有独特的光镜及免疫组化特点,这些特点可与其他滋养细胞疾病鉴别。
Objective: To investigate the clinicopathological and immunohistochemical features of placental trophoblastic tumor (PSTT). Methods: The clinical data of 8 patients with PSTT were collected and re-sliced for histological HE staining and SP immunohistochemical staining and light microscopy. Results: PSTT is a pregnancy-related disease secondary to pregnancy. Common symptoms are amenorrhea and / or vaginal bleeding, with mild to moderate elevated serum chorionic gonadotropin (HCG). Light microscopy of tumor cells as a single implant type of intermediate trophoblast, into a sheet, cord infiltration in the muscle fibers, vascular infiltration, but less hemorrhagic necrosis and intravascular tumor thrombus, mitotic figures rare. Immunohistochemistry showed epithelial membrane antigen (EMA), keratin (CK), human placental prolactin (HPL), moderate to strong positive expression. HCG was only weak positive expression in 1 case, actin (Act), vimentin (Vim) were negative expression. Conclusion: PSTT is a rare trophoblastic tumor with unique characteristics of light microscopy and immunohistochemistry, which can be distinguished from other trophoblastic diseases.