【摘要】 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。更多还原

【Abstract】 Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis,treatment and prognosis of ovarian mature cystic teratoma with malignant transformation. Methods Retrospective analysis of the clinical data was conducted in one case of ovarian mature cystic teratoma with malignant squamous cell transformation,and the histopathological morphology,immunohistochemistry staining,treatment,follow-up data and related literatures were reviewed. Results Under light microscope,ectoderm and endoderm-derived tissues were seen in the tumor,local areas were lined by mature squamous epithelium,pseudostratified ciliated columnar epithelium and smooth muscle tissue. A large majority of squamous epithelium had atypia,loss of polarity,formatted disordered nests and papillary,the nuclear-cytoplasm ratio increased significantly,a large part of the cancer cell nuclei showed pathological mitosis. There were a lot of keratosis substances and keratosis strains,partial areas were visible of fat necrosis and foreign body giant cell reaction; some areas lined mature squamous epithelium also with some degree of atypia.Immunohistochemical staining showed that the cancerous cells were positive of CK5 /6,p63,TRIM29,CK8 /18 was weakly positive,and p53 was strongly positive. The Ki-67-positive rate was about 70%. Conclusion The incidence of ovarian mature cystic teratoma with malignant transformation is rare and therefore,grasping the clinical and pathological features of the disease will play an important role in the diagnosis,differential diagnosis,treatment and prognosis evaluation.更多还原