摘要目的 通过对手术切除获取的睾丸残留物标本进行组织学研究,探究其病理特点,观察该睾丸残留物是否具有日后发展成肿瘤的的病理基础.方法 搜集2008年7月至2015年5月间通过手术获得的睾丸残留物标本187个,常规HE染色及免疫组织化学分析(AR、OCT4、AMH).5个睾丸表皮样囊肿周边部分正常睾丸标本作为对照.结果 187个睾丸残留物标本的组织形态学改变有:纤维变性187个(100％)、钙化94个(50％)及含铁血黄素沉着56个(30％).171个(91％)标本中没有曲细精管;16个(9％)有曲细精管(均在10岁以内),其中4个(2％)有生殖细胞(均在4岁以内).未发现癌前病变.结论 儿童睾丸退化综合征的残留物病理特点主要为纤维增生、钙化、含铁血黄素沉着,仅极少数含有睾丸实体细胞,年龄大于10周岁的患儿精索残端样本中未见曲细精管存在,即支持细胞消失,而日后可能发展成肿瘤的生殖细胞4岁后即消失,未发现癌前病变,不具备青春发育期后形成肿瘤(精原细胞瘤)的病理基础.

abstractsObjective To explore the major pathological characteristic of testicular remnants and examine whether the remnants have the pathological potential of developing into tumor.Methods A total of 187 surgical pathological specimens were collected from 196 patients undergoing scrotal exploration.Histological and immunohistochemical comparisons were made with 5 surgically removed epidermoid testicular cyst testis.Results Routine histological studies showed fibrosis in 187 cases (100％),calcification in 94 cases (50％) and hemosiderin deposition in 56 cases (30％) and no seminiferous tubules in 171 cases (91％).Immunohistochemistry revealed that seminiferous tubule was present in 16 cases (9％) aged ＜10 years and germ cell in 4 cases (2％) aged ＜4 years.Neither malignant cell nor precancerous lesion was found.Conclusions The major pathological characteristics of testicular remnants are fibrosis,calcification and hemosiderin deposition.Only few cases contain parenchyma cells.Seminiferous tubule is absent in those aged ＞ 10 years,it means that sertoli cells disappeared.Germ cells are not present in those cases of older than the age of 4 patients.Germ cells with the tendency of developing into germinoma disappear.Neither malignant cell nor precancerous lesion is found.And the remnants of ETR have no pathological potential of developing into tumor (seminoma) after adolescence.