Visfeldt J, Giwercman A, Skakkebaek N E
University Department of Pathology, Rigshospitalet, Copenhagen, Denmark.
APMIS. 1992 Jan;100(1):63-70. doi: 10.1111/j.1699-0463.1992.tb00840.x.
Discrimination between different types of germ cell tumours may be difficult in routine histological preparations. Additionally, none of the established immunohistochemical markers is completely reliable in diagnosis of embryonal carcinoma. A pilot study indicated that monoclonal antibody 43-9F--a marker of carcinoma-in-situ germ cells--may also react with embryonal carcinoma of the testis. In order to elucidate the applicability of 43-9F in diagnosis of embryonal carcinoma, 42 consecutive testicular germ cell tumours were tested immunohistochemically. Among the 42 tumours, 23 were seminomas and 19 were non-seminomas with seminomatous components in seven of them. Embryonal carcinomas were found in 15 tumours, two being of pure type and the remaining 13 a part of mixed tumours. Additionally, the material included 11 teratomas, nine yolk sac tumours and one choriocarcinoma. Immunohistochemical stainings were performed with 43-9F and additionally with antibodies against placental-like alkaline phosphatase, cytokeratins, alpha-foetoprotein and human chorionic gonadotropin. Using 43-9F a strong colour reaction was found in 13 of the embryonal carcinomas, whereas the reaction was moderate in the remaining two cases. A weak positive reaction was found in six seminomas and the remaining 24 did not react at all. 43-9F exhibited a positive reaction in four of 11 teratomas. The reactivity was generally weak with some focal areas with strong staining. In five cases the yolk sac tumour elements did not stain with this monoclonal antibody. The reaction was weak in three cases and in only one case was the staining intensity scored as moderate. Finally, no reaction was found in the choriocarcinoma element. Compared to the other antibodies tested, including the antibody against cytokeratins, in embryonal carcinoma immunohistochemical staining with 43-9F was more specific, stronger and more constantly expressed. The monoclonal antibody 43-9F may be of value in histological diagnosis of germ cell tumours. Additionally, the study confirmed the pathogenetical link between pre-invasive carcinoma in situ and embryonal carcinoma.
在常规组织学切片中，区分不同类型的生殖细胞肿瘤可能具有一定难度。此外，现有的免疫组化标志物在胚胎癌的诊断中均不完全可靠。一项初步研究表明，单克隆抗体43-9F（原位生殖细胞的标志物）也可能与睾丸胚胎癌发生反应。为了阐明43-9F在胚胎癌诊断中的适用性，对42例连续的睾丸生殖细胞肿瘤进行了免疫组化检测。在这42例肿瘤中，23例为精原细胞瘤，19例为非精原细胞瘤，其中7例含有精原细胞瘤成分。15例肿瘤中发现了胚胎癌，2例为纯型，其余13例为混合肿瘤的一部分。此外，材料中还包括11例畸胎瘤、9例卵黄囊瘤和1例绒毛膜癌。使用43-9F以及抗胎盘样碱性磷酸酶、细胞角蛋白、甲胎蛋白和人绒毛膜促性腺激素的抗体进行免疫组化染色。在15例胚胎癌中，13例使用43-9F时出现强阳性反应，其余2例反应为中度。6例精原细胞瘤出现弱阳性反应，其余24例完全无反应。43-9F在11例畸胎瘤中的4例中呈阳性反应。反应通常较弱，有一些局灶性强染色区域。在5例中，卵黄囊瘤成分未被该单克隆抗体染色。3例反应较弱，仅1例染色强度评分为中度。最后，在绒毛膜癌成分中未发现反应。与其他检测抗体（包括抗细胞角蛋白抗体）相比，在胚胎癌中，43-9F免疫组化染色更具特异性、更强且表达更恒定。单克隆抗体43-9F在生殖细胞肿瘤的组织学诊断中可能具有价值。此外，该研究证实了原位癌前病变与胚胎癌之间的发病机制联系。
