Tian Bao-ling, Gao Ai-feng, Xu Can, Chang Xiao-ying, Xu Zhen-qun, Su Qing-hua, Yang Xiang-hong
Department of Pathology, China Medical University, Shenyang, China.
Zhonghua Bing Li Xue Za Zhi. 2012 Nov;41(11):752-5. doi: 10.3760/cma.j.issn.0529-5807.2012.11.009.
To study the clinicopathologic features and biological behavior of spermatocytic seminoma.
A retrospective analysis of patients diagnosed as seminoma, spermatocytic seminoma between January 2003 and May 2011, was performed. Clinical data, HE stained section and immunohistochemical staining (SP method) were reviewed with follow-up.
Sixty-six cases of seminoma and 5 cases of spermatocytic seminoma were identified. The average age at the diagnosis of 5 cases of spermatocytic seminoma was 53 years, and no patient had a history of crytorchidism or germ cell tumor. All five patients had stage pT1 tumor. Immunohistochemical studies showed that spermatocytic seminoma was negative for CK, vimentin, OCT3/4, PLAP, and LCA, and PAS staining was also negative. All five patients were well after operation. In contrast, the average age at diagnosis of the 66 cases of seminoma was 37 years, in which 12% had a history of crytorchidism and 11% were in stage pT2 or the above. Immunohistochemical studies showed that seminoma was positive for OCT3/4, PLAP, and CD117. During the follow-up, 2 patients developed metastasis and 3 patients died of the disease.
Spermatocytic seminoma is rare and appears to follow a benign clinical course Due to its favourable prognosis, further treatment is not necessary after orchidectomy. Accurate pathologic diagnosis is critical for patient management and for avoiding over-treatment.
研究精母细胞性精原细胞瘤的临床病理特征及生物学行为。
对2003年1月至2011年5月间诊断为精原细胞瘤、精母细胞性精原细胞瘤的患者进行回顾性分析。复习临床资料、HE染色切片及免疫组化染色(SP法)并进行随访。
共鉴定出66例精原细胞瘤和5例精母细胞性精原细胞瘤。5例精母细胞性精原细胞瘤患者的平均诊断年龄为53岁,所有患者均无隐睾症或生殖细胞肿瘤病史。所有5例患者均为pT1期肿瘤。免疫组化研究显示,精母细胞性精原细胞瘤CK、波形蛋白、OCT3/4、PLAP及LCA均为阴性,PAS染色也为阴性。所有5例患者术后情况良好。相比之下,66例精原细胞瘤患者的平均诊断年龄为37岁,其中12%有隐睾症病史,11%为pT2期或更高分期。免疫组化研究显示,精原细胞瘤OCT3/4、PLAP及CD117均为阳性。随访期间,2例患者发生转移,3例患者死于该病。
精母细胞性精原细胞瘤罕见,似乎遵循良性临床病程。因其预后良好,睾丸切除术后无需进一步治疗。准确的病理诊断对患者的管理及避免过度治疗至关重要。