卵巢粒层细胞瘤的诊治  

Diagnosis and treatment of ovarian granulosa cell tumors

作　　者：邓继华[1] 尤勇[2] 

机构地区：[1]四川省大竹县人民医院妇产科,635000 [2]四川省大竹县人民医院病理科,635000

出　　处：《中国实用医刊》2013年第24期40-41,共2页Chinese Journal of Practical Medicine

摘　　要：目的 探讨卵巢粒层细胞瘤的临床表现及辅助检查特点、诊断及治疗要点,以提高对该肿瘤的诊治水平.方法 收集大竹县人民医院1995年3月至2009年5月经病理学确诊为卵巢粒层细胞瘤的13例患者的临床资料,总结分析其临床、影像、病理特点.结果 13例患者年龄47 ～68岁（平均53岁）,临床表现为月经异常或绝经后阴道出血2d～7个月余,伴或不伴腹胀腹痛.术中见肿决位于盆腔卵巢,活动度尚可,表面光滑或微突结节状.超声及CT提示囊实性混合性肿块.病理特征为细胞核有核沟呈咖啡豆样外观,且围绕嗜酸性物质排列成Call-Exner小体结构.免疫组化可表达CD99、inhibin、calretinin、Vimentin.经手术治疗并辅以化疗,12例成人型患者5年、10年生存率分别为100％、91.7％.结论 卵巢粒层细胞瘤是好发于中老年女性的低度恶性肿瘤,临床多表现为月经异常或绝经后阴道出血,其诊断主要靠病理学,治疗以手术为主,辅以化疗,预后较好.掌握上述各特征,施以恰当治疗并长期随访有重要临床意义.Objective To investigate the clinical and pathological features and auxiliary examination of ovarian granulosa cell tumors,and to improve the diagnostic and therapeutic levels.Methods The clinical data of 13 cases who were diagnosed by pathology in Dazhu people＇s hospital from March 1995 to May 2009 were collected and their clinical findings,image shows and pathlogical features were analyzed.Results The patients were 47 to 75 years old（mean 53 years old）,and their clinical manefestations were abnormal menstruation or postmenopause vaginal bleeding for 2 days to 7 months and some patients were complicated with abdominal distention and stomachache.The tumors located in the ovarium with mobility and their surface were smooth or with small nodosity.Their imagings on the ultrosound and CT showed cystica-solid mixed tumors.The nuclear grooves made the nuclei like coffee bean appearance,the cells arranged round the acidoid which called as Call-Exner body.The positve expressed markers by immunohistochemistry stainning were CD99,inhibin,calretinin,and vimentin.The 12 adult granulosa cell tumor patients＇ 5 years and 10 years survival rate was 100％ and 91.7％ respectively,after surgery and chemotherapy.Conclusions The ovarium granulose cell tumors are low grade malignant neoplasms which occurred in middle age to senium females,abnormal menstruation or postmenopause vaginal bleeding are the main clinical symptomas,the certain diagnosis is depended on pathology.The prognosis would be good after surgery excision and then assisted with chemicotherapeutics.It has important clinical signifcance if master all the above characteristics,give appropriate treatment and long-term follow-up.

关 键 词：卵巢 粒层细胞瘤 诊断 

分 类 号：R737.31[医药卫生—肿瘤]