ER、Ki-67与Nestin在儿童未成熟畸胎瘤组织中的表达及临床意义

目的研究雌激素受体（estrogen receptor,ER）、Ki-67与巢蛋白（Nestin）在儿童未成熟畸胎瘤组织中的表达及其临床意义。方法制作35例不同级别儿童畸胎瘤手术病理标本组织芯片,采用免疫组化二步法测定畸胎瘤组织中ER、Ki-67与Nestin的表达水平。患儿男21例,女14例。病理分级未成熟畸胎瘤1级11例,2级13例,3级11例。选取成熟畸胎瘤15例作为对照。所有患儿手术前、后均未进行化疗和放疗。随访内容为肿瘤有无复发、转移,有无大小便失禁、尿潴留等。结果ER、Ki-67、Nestin在不同病理分级畸胎瘤神经上皮组织中随分级升高表达增强,比较差别有统计学意义,在各病理分级儿童畸胎瘤内、中、外胚层（除了神经上皮）组织中表达差异均无统计学意义。随访到29例,2例复发,其余健在,无复发、转移。结论在儿童未成熟畸胎瘤神经上皮组织中,ER、Ki-67、Nestin的表达与病理分级有关,可作为预后判断的参考指标。未成熟畸胎瘤术后化疗指征有待进一步探讨。

The Expression and Significance of ER, Ki-67 and Nestin in Pediatric Immature Teratoma Tissure

Objective To investigate the expression and significance of estrogen receptor（ER）, Ki-67 and Nestin in pediatric immature teratoma tissue. Methods Thirty-five cases（21 male and 14 female） tissue were taken from the surgically resected specimen in Jiangxi Children＇s Hospital. The expressions of ER,Ki-67 and Nestin were detected by immunohistochemistry and tissue chip in teratoma tissues. As a control, 15 mature teratoma tissue were analyzed. The patients were followed up by phone or letters. Results In every pathograde of children teratoma,the expressions of ER,Ki-67, and Nestin in neurepithelium were strengthener with higher grade and there were statistical significance among the differences. In every pathograde of pediatric immature teratoma,there were no statistical significance among the expressions of endoderm,mesoderm and ectoderm（besides neurepithelium）. There were no statistical significance among the differences of the expressions of ER,Ki-67,and Nestin in different invasion positions and different gender. By spearman＇s rank correlation, there were positive correlation relationships among the expressions of ER,Ki-67,and Nestin in children teratoma neurepithelium tissue. Twenty-nine cases were followed up and two cases were recurred and the other were healthy. Conclusion In pediatric immature teratoma neurepithelium tissue,ER, Ki-67 and Nestin The judgment of the children teratoma patient＇s prognosis age.invasion position, pathograde, the information of oper ER, Ki-67 and Nestin in neurepithelium tissue.