卵巢纤维卵泡膜细胞瘤误诊为卵巢恶性肿瘤1例报告及文献复习  

Misdiagnosis of ovarian fibrothecoma as ovarian malignant tumor:A case report and literature review

作　　者：裴燕岭 吕航航 王博蔚[1] 张炜旸[1] PEI Yanling;LYU Hanghang;WANG Bowei;ZHANG Weiyang(Department of Obstetrics and Gynecology,Second Hospital,Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第二医院妇产科

出　　处：《吉林大学学报（医学版）》2019年第4期940-943,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅重点科技研发项目资助课题(20180201056YY)

摘　　要：目的:分析并发腹水和高水平糖类抗原125(CA125)的卵巢纤维卵泡膜细胞瘤患者的临床特点,探讨CA125水平升高的原因及其在鉴别卵巢良恶性肿瘤方面的意义。方法:收集1例并发腹水及高水平血清CA125的卵巢纤维卵泡膜细胞瘤患者的临床资料,结合相关文献,分析其临床特点、诊治过程及血清CA125水平在鉴别卵巢良恶性肿瘤中的意义。结果:患者因阴道流血4个月,检查发现盆腔包块1个月入院,结合术前彩超、增强 CT、血清CA125水平及查体诊断为盆腹腔肿物,考虑为卵巢来源,高度怀疑为卵巢恶性肿瘤。给予手术治疗,术中快速病理和术后慢病理明确诊断为卵巢纤维卵泡膜细胞瘤,手术过程顺利。患者恢复良好出院,术后1个月复查血清CA125水平已降至正常范围。结论:对不同来源CA125糖基化修饰和特异性糖链结构的鉴定以及定量分析,可以明显提高 CA125对卵巢良恶性肿瘤的诊断特异性。Objective:To analyze the clinical features of ovarian fibrothecoma complicated with ascites and high level of CA125,and to explore the causes of elevated CA125 level and its significance in identifying benign and malignant ovarian tumors.Methods:The clinical data of one patient with varian fibrothecoma complicated with ascites and high level of serum CA125;combined with relevant literature review,the clinical characteristics,diagnosis and treatment process,and the significance of CA125 in the differential diagnosis of benign and malignant ovarian tumors were analyzed.Results:The patient was admitted to hospital due to vaginal bleeding for 4 months and pelvic mass for 1 month.The diagnosis result was pelvic and abdominal mass arising from ovarian according to the preoperative color Doppler ultrasound,enhanced CT,serum CA125 level and physical examination,and was highly suspected as ovarian malignant tumor.Surgery treatment was performed;based on the intraoperative rapid pathological results and postoperative slow pathology,the patient was diagnosed as ovarian fibrothecoma;the operation was successful.The patient recovered well and discharged from hospital.The serum CA125 level was decreased to the normal range 1 month after operation.Conclusion:Identification and quantitative analysis of the glycosylation modification and specific glycan structure of CA125 from different sources can significantly improve the diagnostic specificity of CA125 for benign and malignant ovarian tumors.

关 键 词：卵巢纤维卵泡膜细胞瘤 卵巢肿瘤 糖类抗原125 腹水 

分 类 号：R737.31[医药卫生—肿瘤]