摘要目的 探讨颅内生殖细胞肿瘤(GCTs)的血清肿瘤标志物与肿瘤组织免疫组化的相关性.方法 回顾性分析2013年3月至2016年7月清华大学玉泉医院神经外科手术治疗的28例颅内GCTs的临床资料,并进行术前血清肿瘤标志物与术后肿瘤组织免疫组化对照观察,使用甲胎蛋白(AFP)、人绒毛膜促性腺激素(β-HCG)、碱性磷酸酶(ALP)等血清肿瘤标志物表达与相关免疫组化染色进行比较.结果 28例患者中,生殖细胞瘤5例,成熟畸胎瘤2例,未成熟畸胎瘤5例,绒毛膜上皮癌1例,混合性生殖细胞肿瘤15例.28例中,AFP结果不符合8例:表现为血清肿瘤标志物AFP为阳性,免疫组化结果为阴性(其中未成熟畸胎瘤4例,混合性生殖细胞肿瘤4例);β-HCG结果不符5例:表现为血清β-HCG阳性,免疫组化未检出(其中单纯生殖细胞瘤1例,混合性生殖细胞肿瘤4例);本组中含有纯生殖细胞瘤成分的18例中,胎盘碱性磷酸酶(PLAP)免疫组化表达15例,而相对应的血清ALP仅4例明显升高,余14例为阴性.结论 颅内GCTs的治疗和预后与病变包含的不同肿瘤成分有关,免疫组化结合相关肿瘤血清标志物能够更加准确和完整地体现不同的肿瘤成分.

abstractsObjective To conduct the comparative observational study of serum neoplastic biomarker and immunohistochemistry in intracranial getm cell tumors (GCTs).Methods A retrospective study was conducted on clinical data of 28 cases of germ cell tumors undergoing surgery from March 2013 to July 2016 at Tsinghua University Yuquan Hospital.Presurgical serum neoplastic biomarkers including α-fetoprotein (AFP),β-human chorionic gonadotropin (β-HCG) and alkaline phosphatase (ALP) were measured and compared with postsurgical immunohistochemistry results of tumor specimens.Results Among the 28 cases of GCTs,germinoma was identified in 5 cases,teratoma in 2 cases,immature teratoma in 5 cases,choriocarcinoma in 1 case and mixed germ cell tumor in 15 cases.AFP was inconsisent in 8/28 cases,being positive in serum biomarker and negative in immunohistochemistry,and included 4 cases of immature teratoma and 4 mixed GCTs.β-HCG was incongruent in 5 cases (positive in serum and negative in immunohistochemistry).Among the 18 cases with pure germinoma component,placenta ALP (PLAP) immunohistochemistry revealed positive results in 15 cases,while serum ALP was significantly increased in only 4 cases and not detected in the remaining 14 cases.Conclusions The treatment and prognosis of intracranial GCTs might be correlated with different neoplastic components.Immunohistochemistry combined with serum biomarker could help demonstrate those neoplastic components more accurately and completely.