摘要目的 研究分析一种新的肿瘤标志物SALL4在儿童卵黄囊瘤(yolk sac tumor,YST)的表达情况及临床意义.方法 收集儿童卵黄囊瘤病理标本21例(含有穿刺标本8例).选取成熟畸胎瘤(mature teratoma,MT)10例、未成熟畸胎瘤(immature teratoma,IMT)5例、无性细胞瘤1例进行对照研究.应用免疫组织化学方法检测SALL4在上述肿瘤中的表达情况,并就SALL4与甲胎蛋白(alpha fetoprotein,AFP)在YST的表达情况进行比较.结果 ①SALL4在21例儿童YST全部表达,且每例都有较高的阳性表达强度;②在儿童YST中,SALL4的阳性表达强度强,为6例(++)、15例(+++),而AFP在YST的表达相对较弱,分别为2例(-)、5例(+)、9例(++)、5例(+++),SALL4表达强度比AFP更强(P＜0.01);在儿童YST中,SALL4与AFP的表达强度之间进行相关性分析,发现两者无明显相关性(P＞0.05);③8例穿刺标本中,SALL4染色3例(++)、5例(+++),AFP染色1例(-)、2例(+)、4例(++)、1例(+++),两者比较差异有统计学意义(P＜0.05).结论 ①在儿童常见生殖细胞肿瘤(GCT)中,SALL4可能作为YST相对敏感的新一代瘤标;②在免疫组化染色分析中,SALL4比AFP在儿童YST中阳性表达强度更高;但SALL4与AFP的表达强度之间无明显相关性;③SALL4免疫组化染色可帮助儿童YST的诊断,尤其针对组织量少的穿刺标本,更敏感的瘤标SALL4有助于标本的病理分子学诊断.

abstractsObjective To study the expression of SALL4 in yolk sac tumors (YST) in children.Methods Twenty one patients were diagnosed with yolk sac tumor and treated in the children's hospital of Chongqing medical university. Their tumor tissue specimens including 8 puncture biopsy specimens were collected for this study. In addition, 10 cases of mature teratoma (MT), 5 cases of immature teratoma (IMT). 1 dysgerminoma were collected as control The expressions of SALL4 in YST,MT, IMT and dysgerminoma were studied by SP immunohistochemical method. Alpha fetoprotein 21 patients. Among them, the expression of SALL4 in YST was strong ( + + ) in 6 patients, and very It is negative in 2 cases, detectable in 5, strong in 9, and very strong in 5. The expression of SALL4 expression of SALL4 was strong ( + + ) in 3 cases, and very strong ( + + + ) in 5 cases. The staining of AFP was negative in 1 case ( - ), detectable in 2 ( + ), strong in 4 ( + + ) and very strong in 1 ( ++ + ). A significant difference was found between SALL4 and AFP expression in these specimens (P＜0. 05). Conclusions SALL4 could be a new relatively sensitive tumor marker for YST. The expression of SALL4 is stronger than AFP in YST. But their expression doesn't correlate with each other.Immunohistochemical staining of SALL4 could be helpful to diagnose YST in children, especially in the small amount specimens.