卵巢颗粒细胞瘤26例临床病理分析  

Clinical and Pathological Analysis of 26 Cases of Ovarian Granulosa Cell Tumor

作　　者：祝建芳[1] 吴荔香[1] 王成有[1] 

机构地区：[1]福建省妇幼保健院,福建福州350001

出　　处：《实用妇产科杂志》2012年第12期1060-1063,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:对卵巢颗粒细胞瘤(GCT)的临床病理特点及预后进行探讨。方法:回顾性分析26例GCT患者的临床表现、病理特征、免疫组化结果及预后情况。结果:①临床分期及分型:FI-GO分期ⅠA期15例(57.8%),ⅠC期5例(19.2%),ⅡB期3例(11.5%),ⅡC期1例(3.8%),ⅢB期2例(7.7%)。高分化18例,中分化5例,低分化3例。成年型GCT23例,幼年型GCT3例。②肿瘤特征:肿瘤大体上多为表面光滑,分叶状、实性或囊实性肿块,仅1例呈囊性。肿瘤细胞由小圆形、多边形或梭形细胞构成,核呈石榴子样,可见或多或少的纵形核沟及Call-Exner小体。③免疫组化表达:抑制素α(α-inhibin)表达阳性率94.1%(16/17),CD99表达阳性率92.3%(12/13),波形蛋白(Vimentin)表达阳性率94.7%(18/19)。④治疗及随访:1例放弃治疗死亡,其余25例均行手术治疗,联合化疗5例。随访1～6年,ⅢB期2例为中～低分化,肿瘤直径>10cm,已死亡,其余均存活。结论:GCT是低度恶性的卵巢肿瘤,核沟是常见的组织学特征,Call-Exner小体是最常见的排列方式。免疫组化中α-inhibin、CD99和Vimentin是诊断GCT比较有意义的抗体。临床分期、组织学分级等因素均影响预后。Objective： To explore the clinical and pathological features and prognosis factors of ovarian granular cell tumor （GCT）. Methods： Clinical datas of 26 GCT patients including the clinical manifestation, pathological features, immunohistochemistry results and prognosis summarized were retrospectively ana- lyzed. Results：①FIGO stages： Ⅰ A stage 15 cases（57.8%）, I C stage 5 cases（19.2%）, Ⅱ B stage 3 ca- ses（ 11.5% ）, Ⅱ C stage 1 cases（3. 8% ）,Ⅲ B stage 2 cases（7. 7% ） o There were 18 well differentiated ca- ses, 5 middle differentiated cases,3 lower differentiate cases,23 adult form GCT cases,3 juvenile form GCT cases. ②Characteristics of the tumor： Tumors were mostly Iobulated, having smooth surfaces, solid or solid with cystic mass. There was only one case of cystic mass. Tumor cells were composing by small circular, po- lygonal and spindle cells. Nucleus of the tumor cell was garnet-like, and sometimes more or less longitudinal nuclear grooves and CalI-Exner bodies colud be seen. ③lmmunohistochemical expression：The positive ex- pression rate of a-inhibin , CD99 and Vimentin were 94. 1% （ 16/17 ）, 92.3% （ 12/13 ） and 94. 7% （ 18/19 ） respectively. （~Treatment and follow-up：One case died after abandoning the treatment, The remaining 25 ca- ses underwent surgical treatment, and there were five cases combined with chemotherapy or radiotherapy. All cases followed-up 1 to 6 years, two cases died, the rest survived. The died cases were diagnosed as Ⅲ B stage tumor with middle or lower tumor differentiation, and the tumor diameter were larger than 10cm. Con- clusions ：GCT was low-grade malignant ovarian tumor, Nuclear groove is one of the common histologic char acteristics,CalI-Exner bodies is the most common arrangement mode. Inhibin、 CD99 and Vimentin were meaningful antibodies for dignosis. Clinical stage, histological grade are meaningful prognostic indicators.

关 键 词：卵巢肿瘤 颗粒细胞瘤 临床病理 预后 

分 类 号：R737.31[医药卫生—肿瘤]