卵巢颗粒-间质细胞恶性肿瘤的预后相关因素分析

Analysis of prognosis and the related factors of ovarian granulose-malignant stromal cell tumors

目的分析卵巢颗粒-间质细胞恶性肿瘤的预后相关因素,并探讨其最佳治疗方案。方法回顾性研究41例卵巢颗粒-间质细胞恶性肿瘤患者的临床资料,其手术切除的标本由病理科医师测量肿瘤的大小,并经免疫组织化学染色计数肿瘤细胞的核分裂相及观察其分化程度。采用logrank单因素分析和Cox多因素比例风险模型分析各种发病因素与生存率的关系,采用Kaplan-Meier作出生存率曲线图。结果随访545～4791 d,中位数随访时间为2270．8 d。5年生存率为92．5％,10年生存率87．8％。核分裂指数和肿瘤体积与生存率呈正相关(P值均<0．05)。肿瘤分期、细胞分化程度、手术方式和术后化疗与生存率不相关(P值均>0．05)。结论核分裂指数和肿瘤体积是卵巢颗粒-间质细胞恶性肿瘤有价值的预后因素,而术后化疗并不改善患者的预后。

Objectives To evaluate clinical and pathological features of 41 patients with ovarian granulosemalignant stromal cell tumor and to explore the factors relating to the prognosis retrospectively; and to appraise the best treatment regimen for these patients. Methods Data from 41 women with histologically proven granulose-malignant stromal cell tumor of ovary were collected retrospectively. The tumor size was measured by pathologist. Mitotic index and grade of cell differentiation were analyzed by immuno-histochemiscal Log-rank, Cox-test and Kaplan-Meyer methods for estimating the overall survival rates and prognostic factors. Results The follow up duration was 545-4 791 d, with the median follow-up duration 2 270.8 days. The overall survival rates were 92.5% and 87.8% after 5 and 10 years respectively. Among all the clinical and pathological findings, only the mitotic index and the tumor size were positively correlated with the survival rate（P 〈 0.05）. Postoperative chemotherapy tumor staging, cell differenciation, surgical method were not correlated with the prognosis（P 〈 0.05）. Conclusion Mitotic index and tumor size may be the valuable prognostic factors, however chemotherapy after operation can＇t ira prove the patients＇ survival.