原发性输卵管癌的临床表现与超声特征分析

Analysis on related clinical manifestations and ultrasonic features of primary fallopian tube carcinoma

目的探讨原发性输卵管癌(PFTC)的临床表现及其超声特征,并分析漏误诊原因。方法回顾性分析2014年3月至2020年11月经手术病理证实为PFTC的14例患者术前临床资料,分析患者相关临床表现及其超声特征。结果14例被诊断为PFTC的患者,年龄43~59岁,平均(53.00±1.42)岁,其中,9例已绝经,均已生育。常见首发症状依次为阴道流液(28.57%,4/14)、阴道异常出血(28.57%,4/14)、阴道流液并腹痛(21.43%,3/14)、阴道异常出血并腹痛(7.14%,1/14)、腹痛(7.14%,1/14)及体重下降(7.14%,1/14)。PFTC病变输卵管共计17条,术前超声检查结果包括附件区未发现异常声像3条(17.65%,3/17)及附件区发现占位性病变14条(82.35%,14/17)。14个占位性病变的超声声像特征包括:囊性包块7个(50.00%,7/14)、囊实性包块6个(42.86%,6/14)、实性包块1个(7.14%,1/14),呈腊肠状或条状的包块有7个(50.00%,7/14);实性部分探及丰富或较丰富彩色血流信号的包块有6个(42.86%,6/14),实性部分探及少许彩色血流信号的包块有1个(7.14%,1/14),阻力指数为0.35~0.70,平均0.47±0.04。结论PFTC患者临床表现及病灶声像表现多样,诊断需要遵循一定的临床思路,综合各种因素考虑,以提高术前诊断率。

Objective To investigate the clinical manifestations and ultrasonic characteristics of primary fallopian tube carcinoma(PFTC),and to analyze the causes of missed diagnosis and misdiagnosis.Methods The preoperative clinical data of the patients with PFTC confirmed by surgery and pathology from March 2014 to November 2020 were retrospectively analyzed.The relevant clinical manifestations and ultrasonic characteristics were analyzed.Results Fourteen patients were diagnosed as PFTC,aged 43-59 years old,with an average of(53.00±1.42)years old.Nine patients had menopause and had given birth.The common initial symptoms were the vaginal discharge(28.57%,4/14),abnormal vaginal bleeding(28.57%,4/14),vaginal discharge with abdominal pain(21.43%,3/14),abnormal vaginal bleeding with abdominal pain(7.14%,1/14),abdominal pain(7.14%,1/14)and weight loss(7.14%,1/14).There were 17 fallopian tubes with PFTC lesions.The preoperative ultrasound examination results included no abnormal sonograms in the accessory area(17.65%,3/17)and space occupying lesions in the accessory area(82.35%,14/17).The ultrasonographic features of space occupying lesions included cystic mass(50.00%,7/14),cystic solid mass(42.86%,6/14)and solid mass(7.14%,1/14).There were 7 sausage like or strip like masses(50.00%,7/14);the rich or relatively rich color blood flow signals were explored in the solid part of 6 masses(42.86%,6/14),the solid part of 1 mass(7.14%,1/14)showed a little color blood flow signals,and the resistance index was 0.35-0.70,with an average of 0.47±0.04.Conclusion The clinical manifestations and sonographic manifestations of PFTC patients are diverse,which need to follow certain clinical ideas and comprehensively consider various factors in order to improve the preoperative diagnosis rate.