36例卵巢颗粒细胞瘤临床诊断指标探讨

Clinical Characteristics of 36 Patients With Granulosa Cell Tumor

目的探讨卵巢颗粒细胞瘤的临床特点及相关诊断指标特点及临床意义。方法回顾性分析2009年1月-2018年6月福建省妇幼保健院收治的36例卵巢颗粒细胞瘤的临床病理资料,分析该病常见的相关诊断指标特点。结果 I期及Ⅱ~Ⅳ期患者血清雌二醇水平分别为(107.9±36.8) pg/mL及(155.5±46.5) pg/mL,差异无统计学意义(P=0.58)。31例术前影像学发现附件区包块(31/36,86.1%),5例术前影像学未发现(5/36,13.9%),其中4例合并有子宫内膜癌。诊断卵巢颗粒细胞瘤指标的准确率分别为:阴道流血(75.0%),卵巢癌症状指数(52.8%)及血清E2高于105.3 pg/mL(41.7%)。血清CA125及CA199的准确率分别为19.4%及8.3%。绝经前后人群的阴道流血、卵巢癌症状指数及影像学检查差异具有统计学意义(P <0.05)。结论影像学检查结合是否绝经以及阴道流血尤其是合并腹痛、腹胀等临床症状有助于降低卵巢颗粒细胞瘤的漏诊率。

Objective To explore the clinical features,the characteristics of relevant diagnostic indexes and their clinical significance of ovarian granulosa cell tumor.Methods Clinicopathological data of 36 patients with GCT treated in Fujian Provincial Maternity and Children's Hospital from January 2009 to May 2018 were analyzed retrospectively.Analyze the characteristics of common diagnostic indicators of the disease.Results The serum estradiol levels of subject in Phase Ⅰ and Phase Ⅱ~Ⅳ were(107.9±36.8)pg/mL and(155.5±46.5)pg/mL respectively,the difference was not statistically significant(P=0.58).31 subjects were found adnexal masses by preoperative imageological examination(31/36,86.1%),except 5 subjects(5/36,13.9%),four of them were combined with endometrial carcinoma.The accuracy of vaginal bleeding,symptom index,E2 above 105.3 pg/mL,CA125 and CA199 diagnosing GCT were 75.0%,52.8%,41.7%,19.4% and 8.3% respectively.Preoperative imaging positive and vaginal bleeding rate was higher in postmenopausal subjects than the premenopausal subjects,the difference was statistically significant(P<0.05).Conclusion Combining imaging with menopause and vaginal bleeding especially with clinical symptoms such as abdominal pain and bloating would contribute to lower missed diagnosing the GCT.