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目的研究雌激素受体(estrogen receptor,ER)、Ki-67与巢蛋白(Nestin)在儿童未成熟畸胎瘤组织中的表达及其临床意义。方法制作35例不同级别儿童畸胎瘤手术病理标本组织芯片,采用免疫组化二步法测定畸胎瘤组织中ER、Ki-67与Nestin的表达水平。患儿男21例,女14例。病理分级未成熟畸胎瘤1级11例,2级13例,3级11例。选取成熟畸胎瘤15例作为对照。所有患儿手术前、后均未进行化疗和放疗。随访内容为肿瘤有无复发、转移,有无大小便失禁、尿潴留等。结果ER、Ki-67、Nestin在不同病理分级畸胎瘤神经上皮组织中随分级升高表达增强,比较差别有统计学意义,在各病理分级儿童畸胎瘤内、中、外胚层(除了神经上皮)组织中表达差异均无统计学意义。随访到29例,2例复发,其余健在,无复发、转移。结论在儿童未成熟畸胎瘤神经上皮组织中,ER、Ki-67、Nestin的表达与病理分级有关,可作为预后判断的参考指标。未成熟畸胎瘤术后化疗指征有待进一步探讨。
Objective To study the expression of estrogen receptor (ER), Ki-67 and Nestin in immature teratoma in children and its clinical significance. Methods Tissue microarrays of 35 different pathological specimens of teratoma in children were made. The expressions of ER, Ki-67 and Nestin in teratoma tissues were determined by immunohistochemical two-step method. There were 21 males and 14 females. Pathological grade immature teratoma in grade 1 in 11 cases, grade 2 in 13 cases, grade 3 in 11 cases. Fifteen mature teratomas were selected as control. All children without surgery before and after chemotherapy and radiotherapy. Follow-up content of tumor recurrence, metastasis, with or without incontinence, urinary retention and so on. Results The expression of ER, Ki-67 and Nestin in neuroepithelial neoplasia of different pathological grade teratoma increased with the increase of grade, and the difference was statistically significant. In the pathological grade of teratoma, Epithelial) tissue expression differences were not statistically significant. Follow-up to 29 cases, 2 cases of recurrence, the remaining healthy, no recurrence, metastasis. Conclusion The expression of ER, Ki-67 and Nestin in the neuroepithelial tissue of immature teratoma in children is related to the pathological grade, which can be used as a reference index for prognostic judgment. Immature teratoma postoperative chemotherapy remains to be further explored.