卵巢颗粒细胞瘤的临床病理特征及预后分析
发布时间：2018-09-02 06:31
【摘要】：目的:分析卵巢颗粒细胞瘤的临床病理特征,探讨影响卵巢颗粒细胞瘤预后及复发的相关因素。方法:1收集并分析了2005年1月至2016年6月于河北医科大学第四医院诊治的112例卵巢颗粒细胞瘤患者的临床病理资料,包括初诊年龄、临床表现、生育情况、术前血清肿瘤标志物、妇科B超、手术方式、手术途径、肿瘤分期、肿瘤病理特点、术后化疗,术后复发、复发后治疗以及术后生育状况等,通过电话及书信等方式进行随访。2通过SPSS21.0软件建立数据库并进行统计学分析。结果:1一般情况:112例病例资料中,包括成人型卵巢颗粒细胞瘤(AGCT)107例,幼年型卵巢颗粒细胞瘤(JGCT)5例,卵巢颗粒细胞瘤(GCT)患者的平均年龄为46.5±13.93岁,年龄范围为12-75岁。术前血清学CAl25平均水平为118.11±415.61IU/mL,其中有38.50%(35/91)升高。2手术情况:不保留生育功能手术83例(74.10%),手术方式包括:双侧卵巢切除、双侧附件切除或行全子宫切除术。保留生育功能手术29例(25.90%),16例(55.20%)行单侧或双侧卵巢肿瘤剥除术、13例(44.80%)行单侧附件切除术。47例(42.00%)患者行全面分期手术。112例患者中有37例(33.00%)患者行腹腔镜手术,75例(67.00%)行开腹手术。3辅助化疗:83例患者接受术后辅助化疗,疗程为1-16,方案主要为以铂类(顺铂、卡铂、奥沙利铂等)为主的静脉联合化疗,化疗方案有BEP、VAC、TP、TC等。4病理特点:卵巢颗粒细胞瘤最大径线平均为9.25±5.45cm,(1.60cm-48.00cm)。肿瘤位于双侧者2例(1.80%),单侧肿瘤者110例(98.20%)。112例患者重新以最新版FIGO分期标准进行分期,分期结果示:I期105例、II期4例、III期3例,淋巴结均未出现转移。5复发情况:112例患者的平均随访时间为52.63±37.82个月,有11例(9.80%)患者于随访期内复发,平均复发时间间隔为83.09±59.92个月(24-228个月)。6生存分析:截止随访期结束,死亡病例数为7例(6.30%),均因本疾病去世,112例患者中随访时间满5年的患者有42例(37.50%),其中6例患者死亡,1例患者第10年死亡,随访期满10年患者15例(13.39%),7例患者死亡,其中1例死亡患者为Ⅱ期。Ⅰ期GCT的5年生存率和10年生存率分别为85.71%和57.14%。结论:1血清CA125水平不能诊断AGCT和JGCT,但合并腹水患者CA125较无腹水者明显升高。2肿瘤复发可导致5年无疾病生存期缩短。3 GCT患者FIGO分期越晚,越容易复发。4Ⅰ期患者有高危因素化疗可延长患者生存期。5复发患者行满意肿瘤细胞减灭术联合化疗可延长患者生存期。
[Abstract]:Objective: to analyze the clinicopathological features of granulosa cell tumor of ovary and to explore the related factors of prognosis and recurrence of granulosa cell tumor of ovary. Methods from January 2005 to June 2016, we collected and analyzed the clinicopathological data of 112 patients with ovarian granulosa cell tumor treated in the fourth Hospital of Hebei Medical University, including age, clinical manifestation and fertility. Preoperative serum tumor markers, gynecological B-mode ultrasound, surgical approach, tumor staging, tumor pathological features, postoperative chemotherapy, postoperative recurrence, post-recurrence treatment and post-operative fertility, etc. Follow-up by phone and letter. 2. Establish database and statistical analysis by SPSS21.0 software. Results of the 112 cases, 10 7 were adult granulosa cell tumor (AGCT) and 5 were juvenile granulosa cell tumor (JGCT). The average age of (GCT) patients with ovarian granulosa cell tumor was 46. 5 卤13. 93 years, and the age range was 12 to 75 years old. The mean preoperative serological CAl25 level was 118.11 卤415.61 IU / mL. 38.50% (35 / 91) of them had increased 2.2. operation: 83 cases (74.10%) were operated without preserving reproductive function. The operative methods included bilateral ovariectomy, bilateral appendage resection or total hysterectomy. Of 29 cases (25.90%), 16 cases (55.20%) underwent unilateral or bilateral ovarian tumor excision, 13 cases (44.80%) underwent unilateral adnexectomy. 47 cases (42.00%) underwent comprehensive staging surgery. 37 cases (33.00%) underwent laparoscopic surgery, 75 cases (67.00%) underwent laparoscopic surgery. Postoperative adjuvant chemotherapy was performed in 83 patients with 3 cases of adjuvant chemotherapy after open surgery. The course of treatment was 1-16. The main regimen was intravenous chemotherapy with platinum (cisplatin, carboplatin, oxaliplatin, etc.). The chemotherapy regimen had BEP,VAC,TP,TC and other pathological characteristics: the average maximum diameter of granulosa cell tumor was 9.25 卤5.45 cm, (1.60cm-48.00cm). Two cases (1.80%) of tumors were located on both sides and 110 cases (98.20%) of unilateral tumors were re-staging according to the latest FIGO staging standard. The mean follow-up time was 52.63 卤37.82 months, 11 cases (9.80%) recurred during the follow-up period, the mean recurrence interval was 83.09 卤59.92 months (24-228 months), and the mean survival time was 83.09 卤59.92 months (24-228 months). There were 7 cases (6.30%) died, 42 cases (37.50%) were followed up for more than 5 years, 6 cases died in the tenth year, and 15 cases (13.39%) died in 10 years. The 5-year and 10-year survival rates of stage 鈪，
本文编号：2218547
[Abstract]:Objective: to analyze the clinicopathological features of granulosa cell tumor of ovary and to explore the related factors of prognosis and recurrence of granulosa cell tumor of ovary. Methods from January 2005 to June 2016, we collected and analyzed the clinicopathological data of 112 patients with ovarian granulosa cell tumor treated in the fourth Hospital of Hebei Medical University, including age, clinical manifestation and fertility. Preoperative serum tumor markers, gynecological B-mode ultrasound, surgical approach, tumor staging, tumor pathological features, postoperative chemotherapy, postoperative recurrence, post-recurrence treatment and post-operative fertility, etc. Follow-up by phone and letter. 2. Establish database and statistical analysis by SPSS21.0 software. Results of the 112 cases, 10 7 were adult granulosa cell tumor (AGCT) and 5 were juvenile granulosa cell tumor (JGCT). The average age of (GCT) patients with ovarian granulosa cell tumor was 46. 5 卤13. 93 years, and the age range was 12 to 75 years old. The mean preoperative serological CAl25 level was 118.11 卤415.61 IU / mL. 38.50% (35 / 91) of them had increased 2.2. operation: 83 cases (74.10%) were operated without preserving reproductive function. The operative methods included bilateral ovariectomy, bilateral appendage resection or total hysterectomy. Of 29 cases (25.90%), 16 cases (55.20%) underwent unilateral or bilateral ovarian tumor excision, 13 cases (44.80%) underwent unilateral adnexectomy. 47 cases (42.00%) underwent comprehensive staging surgery. 37 cases (33.00%) underwent laparoscopic surgery, 75 cases (67.00%) underwent laparoscopic surgery. Postoperative adjuvant chemotherapy was performed in 83 patients with 3 cases of adjuvant chemotherapy after open surgery. The course of treatment was 1-16. The main regimen was intravenous chemotherapy with platinum (cisplatin, carboplatin, oxaliplatin, etc.). The chemotherapy regimen had BEP,VAC,TP,TC and other pathological characteristics: the average maximum diameter of granulosa cell tumor was 9.25 卤5.45 cm, (1.60cm-48.00cm). Two cases (1.80%) of tumors were located on both sides and 110 cases (98.20%) of unilateral tumors were re-staging according to the latest FIGO staging standard. The mean follow-up time was 52.63 卤37.82 months, 11 cases (9.80%) recurred during the follow-up period, the mean recurrence interval was 83.09 卤59.92 months (24-228 months), and the mean survival time was 83.09 卤59.92 months (24-228 months). There were 7 cases (6.30%) died, 42 cases (37.50%) were followed up for more than 5 years, 6 cases died in the tenth year, and 15 cases (13.39%) died in 10 years. The 5-year and 10-year survival rates of stage 鈪，
本文编号：2218547
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