Sung Ming-Tse, Jones Timothy D, Beck Stephen D, Foster Richard S, Cheng Liang
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Hum Pathol. 2006 Jun;37(6):662-7. doi: 10.1016/j.humpath.2006.01.019.
Correctly diagnosing a metastatic germ cell tumor after chemotherapy may be challenging because of the diverse morphological manifestations of postchemotherapy tumors. Both OCT4 and CD30 are sensitive markers for the identification of primary embryonal carcinomas; however, loss of expression of CD30 (65%) has been reported in metastatic embryonal carcinomas after chemotherapy. The present study was conducted to evaluate the expression patterns of OCT4 and CD30 in postchemotherapy metastatic embryonal carcinomas and to compare their utility as diagnostic tools. Twenty-five cases of metastatic embryonal carcinoma after chemotherapy were immunohistochemically analyzed for CD30, OCT4, and cytokeratin AE1/AE3 expression. The staining intensities and the percentages of positively staining tumor cells were recorded. Nineteen (76%) of 25 cases revealed diffuse, moderate to strong nuclear OCT4 staining in postchemotherapy embryonal carcinomas. Among these 19 OCT4-positive cases, 8 also revealed diffuse and moderate to strong membranous CD30 staining. Seven of these OCT4-positive cases retained focal and weak CD30 expression. The remaining 4 OCT4-positive cases demonstrated a complete loss of CD30 expression. The 19 OCT4-positive cases showed a positive but variable cytokeratin AE1/AE3 expression pattern. Six (24%) of 25 cases were negative for both CD30 and OCT4 but demonstrated diffuse and strong cytokeratin AE1/AE3 staining. OCT4 is a useful diagnostic marker to identify metastatic embryonal carcinomas after chemotherapy, with a better sensitivity than CD30.
由于化疗后肿瘤的形态表现多样，正确诊断化疗后的转移性生殖细胞肿瘤可能具有挑战性。OCT4和CD30都是识别原发性胚胎癌的敏感标志物；然而，据报道化疗后转移性胚胎癌中CD30表达缺失的情况占65%。本研究旨在评估OCT4和CD30在化疗后转移性胚胎癌中的表达模式，并比较它们作为诊断工具的效用。对25例化疗后转移性胚胎癌进行免疫组织化学分析，检测CD30、OCT4和细胞角蛋白AE1/AE3的表达。记录染色强度和阳性染色肿瘤细胞的百分比。25例中有19例（76%）在化疗后的胚胎癌中显示弥漫性、中度至强核OCT4染色。在这19例OCT4阳性病例中，8例还显示弥漫性、中度至强膜CD30染色。这些OCT4阳性病例中有7例保留局灶性、弱CD30表达。其余4例OCT4阳性病例显示CD30表达完全缺失。19例OCT4阳性病例显示细胞角蛋白AE1/AE3表达呈阳性但存在差异。25例中有6例（24%）CD30和OCT4均为阴性，但显示弥漫性、强细胞角蛋白AE1/AE3染色。OCT4是识别化疗后转移性胚胎癌的有用诊断标志物，其敏感性优于CD30。
