摘 要：目的：探讨α-抑制素、CD99、EMA在卵巢性索间质肿瘤中的表达情况及在该类肿瘤的诊断、鉴别诊断及预后等方面的意义，为临床病理诊断和鉴别诊断提供科学依据。方法：收集我院病理确诊的卵巢性索间质肿瘤41例，其中颗粒细胞瘤21例，卵泡膜纤维瘤11例，环状小管性索瘤4例, 支持间质细胞瘤3例，卵巢支持细胞瘤2例。同时选择10例卵巢上皮性肿瘤作为对照进行对比观察(见附表)。所有标本均经中性福尔马林固定，4um切片，用SP法免疫组化标记，α- 抑制素、CD99、EMA均为鼠抗单克隆抗体。DAB显色后，苏木素复染、中性树胶封固。以正常一抗动物血清代替一抗做阴性对照，抗体由北京中山生物技术公司提供。结果判定:α-抑制素阳性在核或浆，CD99阳性表达在细胞膜或浆。结果：颗粒细胞瘤21例中，α-抑制素19例阳性,阳性率为90.5%,CD99 有17例阳性,阳性率80.9%；卵泡膜纤维瘤11例中，α-抑制素9例阳性,CD99均为阳性；环状小管性索瘤4例，α- 抑制素均为阳性,CD99 3例阳性；支持间质细胞瘤3例、支持细胞腺瘤2例，α-抑制素、CD99均为阳性,幼年性颗粒细胞瘤复发者1例两次均为阳性。结论：α-抑制素、CD99联合应用标记性索间质肿瘤有很高的敏感性和特异性，对区分性索间质肿瘤类型、判定复发、预后、转移有重要意义，其效果明显优于单纯应用CD99、苗勒抑制物、Melan- A等标记物。

    关键词： 卵巢性索间质肿瘤； 免疫组化； α- 抑制素； CD99

    Investigate the Expression of α-inhibin、CD99 in Ovarian Sex Gonad Stromal Tumors

    REN Yong-chang, ZHEN Hong-wei, ZHU Su-ling, et al

    (The Central Hospital of Yishui City, Shandong Linyi 276400, China)

    Abstract： Objective： To investigate the expression of α-inhibin, CD99, EMA in ovarian sex gonad stromal tumors and the significance in diagnosis, differential diagnosis and prognosis of these tumors. To provide more scientific bases for clinical pathologic diagnosis and differential diagnosis.Method： 41 specimens and clinical history were collected including 21 cases of granulosa cell tumor, 11 cases of ovarian fibroma, 4 cases of sex cord tumor with annular tubules, 3 cases of sertoli-leydig cell tumor and 2 cases of ovarian sertoli cell tumor.And 10 cases of ovarian epithelial tumor are selected as controls (see the attached table). All these specimens are processed neutral formaldehyde solution fixation, 4um section; then labeling with SP immunohistochemistry, α-inhibin, CD99, EMA are murine monoclonal antibody, after DAB ,neutral gum mounting at last. Instead of primary anti, we use normal primary anti animal blood serum as the negative contrast, the antibody is provided by Beijing zhongshan biotechnology company. Result： Determination:α-inhibin positive occurs on cell nucleus or cell plasm, CD99 positive occurs on cell membrance or plasm. In the 21 cases of granulosa cell tumor, 19 cases are α-inhibin positive, positive rate is 90.5%; 17 cases are CD99 positive, positive rate is 80.9%; In the 11 cases of ovarian fibroma, 9 cases are α- inhibin positive, all these cases are CD99 positive;In 4 cases of sex cord tumor with annular tubules, all of them are α-inhibin positive and 3 cases CD99 positive. In 3 cases of sertolileying cell tumor and 2 cases of ovarian sertoli cell adeoma,all of them are both α-inhibin positive and CD99 positive. In 1 case of repea childhood granulosa cell tumor both are positive in primary and relapse. Conclusion： High sensibitity and specificity can be obtained by labelling sex gonad stromal tumors with the combination of α-inhibin and CD99. It has important significance in distinguishing the types of sex gonad stromal tumors, determining relapes, prognosis and metastasis. It is superior to use CD99,mullenian inhibiting substance ,Melan- A purely and proper to wide usage. ......