生殖系统卵黄囊瘤临床及CT/MRI特征研究  

Clinical and CT/MRI features of yolk sac tumor in the reproductive system

作　　者：王柯懿 张文渊[2] 肖学红[1] 汪泽燕[1] 龙秀珍 WANG Keyi;ZHANG Wenyuan;XIAO Xuehong;WANG Zeyan;LONG Xiuzhen(Imaging Center,Zhongshan City People's Hospital,Zhongshan,Guangdong Province 528400,China;Department of Pharmacy,Zhongshan City People's Hospital,Zhongshan,Guangdong Province 528400,China;Zhuhai Cam pus of Zunyi Medical University,Zhuhai,Guangdong Province 519090,China)

机构地区：[1]中山市人民医院影像中心,广东中山528400 [2]中山市人民医院药学部,广东中山528400 [3]遵义医科大学珠海校区,广东珠海519090

出　　处：《实用放射学杂志》2023年第1期87-90,共4页Journal of Practical Radiology

摘　　要：目的 回顾性分析生殖系统卵黄囊瘤(YST)的临床及影像学特征.方法 选取经病理证实为生殖系统YST的20例患者(女性卵巢11例、男性睾丸9例),分析患者首诊临床特征、肿瘤标志物及以CT、MRI为主的影像学数据.结果 72.7%(8/11)的女性患者首诊伴有腹痛,44.4%(4/9)的男性患者首诊伴肿瘤部位疼痛.女性患者均可见明显的盆腔或腹腔积液,男性患者未见明显腹腔积液,但有3例可见阴囊积液.YST患者治疗前甲胎蛋白(AFP)水平普遍升高[女性(10 207±7 405)ng/mL,男性(6 934±15 063)ng/mL,P=0.07],CA125 水平部分升高[女性(350±278)U/mL,男性(30.3±9.8)U/mL,P<0.05].患者治疗前影像学测量肿瘤最大径:女性(141±28)mm,男性(49.5±22.1)mm(P<0.01).卵巢YST瘤影像学上多表现为囊性成分为主,睾丸YST则表现为实性成分为主.磁共振泌尿系水成像(MRU)显示4例女性患者伴输尿管扩张,其中2例伴有尿频、尿急症状.7例男性患者观察到肿瘤同侧精索增粗.结论 女性生殖系统YST患者首诊临床症状严重程度及肿瘤标志物(AFP、CA125)水平通常高于男性.肿瘤影像学表现均呈血供丰富、坏死明显的特点,其中女性肿瘤最大径、肿瘤坏死率以及输尿管扩张发生率均高于男性.Objective The clinical and imaging features of yolk sac tumor(YST)in the reproductive systems were analyzed retrospectively.Methods Twenty patients with pathologically confirmed YST in the reproductive system(11 ovaries and 9 testis)were selected.The clinical features,tumor markers and main CT/MRI data were analyzed.Results 72.7%(8/11)of the female patients had abdominal pain,and 44.4%(4/9)of the male patients had pain at the tumor site at the first visit.All the female patients showed obvious pelvic or abdominal effusion.There was no obvious abdominal effusion in the male patients,but scrotal effusion was found in 3 patients.Alpha-fetoprotein(AFP)generally increased in patients with YST before treatment[female(10207±7405)ng/mL vs male(6934±15063)ng/mL,P=0.07].CA125 levels were partially increased[female(350±278)U/mL vs male(30.3±9.8)U/ml,P<0.05].The mean maximum tumor diameter was(141±28)mm for females and(49.5±22.1)mm for males(P<0.01).The YST imaging features in the ovarian were predominantly cystic,and the testis were predominantly solid.Magnetic resonance urography(MRU)showed 4 female patients with ureteral dilatation,2 of which had symptoms of urgency-frequency urination.7 male patients were observed thickened spermatic cords on the ipsilateral side of the tumor.Conclusion The severity of clinical symptoms and the levels of tumor markers(AFP,CA125)in female patients with YST in the reproductive system is higher than that of male patients.The imaging of tumors showed the characteristics of rich blood supply and obvious necrosis.The maximum tumor diameter,the incidence of tumor necrosis and ureteral dilatation in female patients were higher than those in male patients.

关 键 词：卵黄囊瘤 生殖系统 计算机体层成像 磁共振成像 

分 类 号：R737[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R445.2