Jung Shih-Ming, Chu Pao-Hsien, Shiu Tzu-Fang, Wu Hsueh-Hua, Kuo Tseng-Tong, Chu Jaw-Ji, Lin Pyng-Jing
Department of Pathology, Chang Gung Children Hospital, Taipei, Taiwan.
Appl Immunohistochem Mol Morphol. 2006 Sep;14(3):273-5. doi: 10.1097/00129039-200609000-00004.
Primary germ cell tumors (GCTs) and thymoma are both located in the anterior mediastinum. A previous study has postulated that octamer binding transcription factor (OCT4) is a nuclear transcription factor that is expressed in pluripotent embryonic germ cells. This study examined OCT4 expression in GCTs and thymoma originating from the mediastinum. A retrospective study included 46 consecutive patients with GCTs conducted between 1983 and 2005, and 22 consecutive thymoma in the mediastinum whose tumors had been surgically excised. The 46 primary GCTs in mediastinum included teratoma (n=27; 58.7%), seminoma (n=10; 21.7%), yolk sac tumor (n=6; 13%), embryonal carcinoma (n=1; 2.1%), and mixed GCTs (n=2; 4%; one consisted of teratoma and yolk sac tumor, and the other teratoma, yolk sac tumor, and seminoma); and 22 thymoma including World Health Organization type A (n=3, 13.6%), type AB (n=4, 18.2%), type B1 (n=6, 27.3%), type B2 (n=4, 13.6%), and type B3 (n=5, 22.7%). Each tumor was examined with hematoxylin and eosin staining, and with antibodies to OCT4. All 10 seminoma cases, 1 embryonal carcinoma case, and 1 mixed GCT case containing seminoma were immunopositive for OCT4. On the other hand, the 22 thymoma, 6 yolk sac tumor, 27 teratomas, and 1 case with mixed GCT without component of seminoma were immunonegative for OCT4. We conclude that immunostaining with antibodies to OCT4 is a useful diagnostic tool in the identification of seminomas and primary embryonal carcinomas in GCTs originating from the mediastinum.
原发性生殖细胞肿瘤（GCTs）和胸腺瘤均位于前纵隔。先前的一项研究推测，八聚体结合转录因子（OCT4）是一种在多能胚胎生殖细胞中表达的核转录因子。本研究检测了起源于纵隔的GCTs和胸腺瘤中OCT4的表达情况。一项回顾性研究纳入了1983年至2005年间连续的46例GCTs患者，以及22例纵隔胸腺瘤患者，这些患者的肿瘤均已手术切除。46例纵隔原发性GCTs包括畸胎瘤（n = 27；58.7%）、精原细胞瘤（n = 10；21.7%）、卵黄囊瘤（n = 6；13%）、胚胎癌（n = 1；2.1%）和混合性GCTs（n = 2；4%；其中一例由畸胎瘤和卵黄囊瘤组成，另一例由畸胎瘤、卵黄囊瘤和精原细胞瘤组成）；22例胸腺瘤包括世界卫生组织A型（n = 3，13.6%）、AB型（n = 4，18.2%）、B1型（n = 6，27.3%）、B2型（n = 4，13.6%）和B3型（n = 5，22.7%）。对每个肿瘤进行苏木精-伊红染色，并使用抗OCT4抗体进行检测。所有10例精原细胞瘤病例、1例胚胎癌病例以及1例含有精原细胞瘤成分的混合性GCT病例OCT4免疫呈阳性。另一方面，22例胸腺瘤、6例卵黄囊瘤、27例畸胎瘤以及1例无精原细胞瘤成分的混合性GCT病例OCT4免疫呈阴性。我们得出结论，使用抗OCT4抗体进行免疫染色是鉴别起源于纵隔的GCTs中的精原细胞瘤和原发性胚胎癌的一种有用的诊断工具。
