PDF(Pubmed)
Abstract：
UNASSIGNED: Gestational trophoblastic tumors are very rare neoplasms. We determined the distinctive morphological, immunohistochemical, and clinical features of placental site trophoblastic tumors (PSTT) and epithelioid trophoblastic tumors (ETT) in our cohort.
UNASSIGNED: Nine cases of PSTT and four cases of ETT were retrieved from the archives. Histomorphologic, immunohistochemical, and clinical features were noted. A molecular study was performed on one PSTT and one ETT case using next-generation sequencing.
UNASSIGNED: While the nodular pattern, geographic necrosis, and extracellular eosinophilic globules were peculiar to ETTs, vessel wall affinity, marked pleomorphism, intranuclear pseudoinclusion, spindle tumor cell, and vacuolar degeneration were more specific for PSTTs in our series. An immunohistochemical panel of p63, hPL, and CD146 were helpful for the exact typing of the tumor. p63 positivity supports the ETT and diffuse staining of hPL and CD146 supports the PSTT diagnosis. Three of the patients with metastatic disease (lung and brain metastasis) except one have a high mitotic count (12 and 8) and a long interval between (8 and 10 years) antecedent pregnancy and diagnosis. While KIT and TP53 mutations were observed only in PSTT, amino acid changes in KDR, APC, and SMAD4 genes were detected both in the ETT and PSTT cases.
UNASSIGNED: In the prediction of metastasis, the long intervals between antecedent pregnancy and diagnosis, deep myometrial invasion, mitotic count, and Ki67 proliferation index were involved rather than other histomorphological parameters, but none of the parameters is an absolute predictor of the metastasis.
UNASSIGNED: Nine cases of PSTT and four cases of ETT were retrieved from the archives. Histomorphologic, immunohistochemical, and clinical features were noted. A molecular study was performed on one PSTT and one ETT case using next-generation sequencing.
UNASSIGNED: While the nodular pattern, geographic necrosis, and extracellular eosinophilic globules were peculiar to ETTs, vessel wall affinity, marked pleomorphism, intranuclear pseudoinclusion, spindle tumor cell, and vacuolar degeneration were more specific for PSTTs in our series. An immunohistochemical panel of p63, hPL, and CD146 were helpful for the exact typing of the tumor. p63 positivity supports the ETT and diffuse staining of hPL and CD146 supports the PSTT diagnosis. Three of the patients with metastatic disease (lung and brain metastasis) except one have a high mitotic count (12 and 8) and a long interval between (8 and 10 years) antecedent pregnancy and diagnosis. While KIT and TP53 mutations were observed only in PSTT, amino acid changes in KDR, APC, and SMAD4 genes were detected both in the ETT and PSTT cases.
UNASSIGNED: In the prediction of metastasis, the long intervals between antecedent pregnancy and diagnosis, deep myometrial invasion, mitotic count, and Ki67 proliferation index were involved rather than other histomorphological parameters, but none of the parameters is an absolute predictor of the metastasis.
摘要：
■妊娠滋养细胞肿瘤是非常罕见的肿瘤。我们确定了独特的形态学，免疫组织化学，胎盘部位滋养细胞肿瘤（PSTT）和上皮样滋养细胞肿瘤（ETT）的临床特征。
■从档案中检索到9例PSTT和4例ETT。组织形态学,免疫组织化学，并注意到临床特征。使用下一代测序对一个PSTT和一个ETT病例进行了分子研究。
■虽然结节状图案，地理坏死，细胞外嗜酸性粒细胞是ETT特有的，血管壁亲和力，标记的多态性，核内假包涵体,梭形肿瘤细胞，在我们的系列中，空泡变性对PSTT更具特异性。p63，hPL的免疫组织化学面板，CD146有助于肿瘤的准确分型。p63阳性支持ETT和hPL的弥漫性染色，CD146支持PSTT诊断。除一名外，三名患有转移性疾病（肺和脑转移）的患者的有丝分裂计数较高（12和8），并且在怀孕前和诊断之间有很长的间隔（8和10年）。虽然仅在PSTT中观察到KIT和TP53突变，KDR中的氨基酸变化，APC,在ETT和PSTT病例中均检测到SMAD4基因。
■在预测转移时，前期妊娠和诊断之间的长间隔，深肌层浸润，有丝分裂计数,涉及Ki67增殖指数，而不是其他组织形态学参数，但是这些参数都不是转移的绝对预测指标。
■从档案中检索到9例PSTT和4例ETT。组织形态学,免疫组织化学，并注意到临床特征。使用下一代测序对一个PSTT和一个ETT病例进行了分子研究。
■虽然结节状图案，地理坏死，细胞外嗜酸性粒细胞是ETT特有的，血管壁亲和力，标记的多态性，核内假包涵体,梭形肿瘤细胞，在我们的系列中，空泡变性对PSTT更具特异性。p63，hPL的免疫组织化学面板，CD146有助于肿瘤的准确分型。p63阳性支持ETT和hPL的弥漫性染色，CD146支持PSTT诊断。除一名外，三名患有转移性疾病（肺和脑转移）的患者的有丝分裂计数较高（12和8），并且在怀孕前和诊断之间有很长的间隔（8和10年）。虽然仅在PSTT中观察到KIT和TP53突变，KDR中的氨基酸变化，APC,在ETT和PSTT病例中均检测到SMAD4基因。
■在预测转移时，前期妊娠和诊断之间的长间隔，深肌层浸润，有丝分裂计数,涉及Ki67增殖指数，而不是其他组织形态学参数，但是这些参数都不是转移的绝对预测指标。
