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目的探讨卵巢囊性成熟型畸胎瘤癌变的临床病理特征、诊断和鉴别诊断、治疗及预后。方法分析1例卵巢囊性成熟型畸胎瘤鳞癌变患者的临床资料、组织病理形态、免疫组化染色、治疗并复习相关文献。结果光镜下肿瘤内可见外胚层衍化的组织,局部衬覆成熟的鳞状上皮、假复层纤毛柱状上皮及平滑肌组织,部分区域鳞状上皮异型性增生,极性消失,排列紊乱,形成巢状和乳头状,部分肿瘤细胞核大,核质比明显增高,可见病理性核分裂象,有大量角化物质及角化珠形成,局部可见脂肪坏死及异物巨细胞反应;局部边缘成熟的鳞状上皮细胞亦有一定的异型增生。免疫组化染色结果显示癌变细胞CK5/6、p63、TRIM29(+),CK8/18部分弱(+),p53强(+),Ki-67阳性率约70%。结论卵巢囊性成熟型畸胎瘤癌变十分少见,掌握其临床病理特征对该病的诊断、鉴别诊断、治疗及预后具有重要意义。
Objective To investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of ovarian cystic mature teratoma. Methods The clinical data, histopathology, immunohistochemical staining, treatment and review of one case of squamous cell carcinomas of ovarian cystic maturity were reviewed. Results Under the light microscope, the ectoderm-derived tissues were seen in the tumor. The mature squamous epithelium and pseudostratified ciliated columnar epithelium and smooth muscle tissue were locally covered. The squamous epithelial hyperplasia in some areas disappeared and the polarity disappeared and became disorganized. And papillary, part of the tumor nuclei, significantly increased nuclear mass ratio, showing pathological mitosis, a large number of keratinized material and the formation of keratosis beads, locally visible fat necrosis and foreign body giant cell response; local edge of the mature squamous epithelium Cells also have some dysplasia. Immunohistochemical staining showed that the positive rates of CK5 / 6, p63, TRIM29 (+) and CK8 / 18 in cancerous cells were weak (+), and the positive rates of p53 and Ki-67 were about 70%. Conclusions Ovarian cystic maturation teratoma is very rare and its clinical and pathological features are of great importance in the diagnosis, differential diagnosis, treatment and prognosis of the ovarian cystic teratoma.