卵巢Sertoli-Leydig细胞瘤17例临床病理分析

发布时间：2018-02-16 05:48

本文关键词： 卵巢肿瘤 Sertoli-Leydig细胞瘤病理诊断治疗及预后　出处：《中国妇产科临床杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨卵巢Sertoli-Leydig细胞瘤(SLCT)的临床病理学特征、诊断及预后。方法回顾性分析2009年2月至2017年2月17例卵巢SLCTs的临床表现、病理学特征、免疫组化结果、治疗及预后。结果 17例患者平均年龄为(46.9±14.4)岁,均发生于单侧卵巢。肿瘤最大径1~18.6 cm,平均最大径为(5.6±4.9)cm。切面呈淡黄色、鱼肉状,实性或囊实性,偶见出血及坏死。镜下肿瘤由不同比例的Sertoli细胞和Leydig细胞组成,根据Sertoli细胞呈腺管状分化程度及原始性腺间质的数量将肿瘤分成高、中、低分化,其中高分化者3例,中分化5例,低分化者9例。免疫组化显示,CK、Vimentin、α-inhibin、Calretinin、CD99、WT-1及Melan A呈阳性表达,而EMA、Cg A及Syn均呈阴性。根据患者年龄、生育状况、病理组织学分级不同而实施范围不同的手术方式,其中7例中-低分化者术后实施辅助化疗。随访1~83个月,中位随访时间为8个月,所有患者均无瘤存活。结论 SLCTs是少见的卵巢性索-间质肿瘤,术后病理对肿瘤诊断及提示预后有重要意义,大部分患者规范化治疗后预后良好。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and prognosis of ovarian Sertoli-Leydig cell tumor. Methods the clinical manifestations, pathological features and immunohistochemical results of ovarian SLCTs from February 2009 to February 17th 2017 were retrospectively analyzed. Results the mean age of 17 patients was 46.9 卤14.4 years old, all of them occurred in unilateral ovary. The maximum diameter of the tumor was 1 ~ 18.6 cm and the average diameter was 5.6 卤4.9 cm. The cut surface was yellowish yellow, fishlike, solid or cystic. The tumor was composed of different proportion of Sertoli cells and Leydig cells under microscope. According to the degree of tubular differentiation of Sertoli cells and the number of primary gonadal stroma, the tumors were divided into high, middle and low differentiation, among which 3 cases were highly differentiated. There were 5 cases of moderate differentiation and 9 cases of low differentiation. Immunohistochemical staining showed the positive expression of Vimentin, 伪 -inhibinus Calretininus CD9T WT-1 and Melan A, but negative expression of EMA-CG A and Syn. According to the patient's age, fertility status and histopathological grade, the operative methods were different. Seven of them received adjuvant chemotherapy after operation. The median follow-up time was 8 months and the median follow-up time was 8 months. Conclusion SLCTs is a rare ovarian cord-stromal tumor. Postoperative pathology plays an important role in tumor diagnosis and prognosis, and the majority of patients have a good prognosis after standardized treatment.
【作者单位】：北京大学人民医院病理科;
【分类号】：R737.31

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