卵巢卵黄囊瘤的声像图特征、临床病理与预后分析

Ultrasonographic,clinicopathologic,and prognostic features of ovarian yolk sac tumor

目的分析并总结卵巢卵黄囊瘤(OYST)的声像图特征、临床病理特点及预后。方法回顾性分析2010年1月至2020年12月在南京大学医学院附属鼓楼医院行超声检查、经手术病理证实的OYST患者10例,记录患者的临床资料、声像图特点、病理结果及分期、治疗方式及预后。通过与病理结果进行对照,分析各例患者超声特点,总结能够提示OYST的主要或特定声像图特征。结果OYST患者年龄偏小(≤30岁),肿块体积大(最大径94~265 mm),肿瘤内部回声以实性为主,常单侧发病,形状规则,血流信号丰富,甲胎蛋白常异常增高(多数>1000 ng/ml)。10例OYST患者均选择手术治疗,其中1例患者手术后因肿瘤全身转移伴盆腔脓肿死亡,1例合并妊娠者足月顺产一健康婴儿。2例ⅢA期患者死亡,2例ⅢC期及6例ⅠC期患者均无瘤生存,其中6例患者保留生育功能,化疗后3个月内均恢复正常月经,3例患者已完成生育,生育子女健康。结论OYST具有某些特定的超声征象,正确认识其声像图特征并结合相关临床及实验室检查,对于该病的术前评估至关重要。

Objective To analyze and summarize the ultrasonographic,clinicopathologic,and prognostic features of ovarian yolk sac tumor(OYST).Methods Ten patients with OYST confirmed by ultrasonography at Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2010 to December 2020 were analyzed retrospectively.The clinical data of the patients were recorded.Ultrasonographic characteristics,pathological results,tumor stage,treatment,and prognosis were also recorded.The ultrasonographic characteristics of each case were analyzed to identify the main or specific ultrasonographic characteristics indicating OYST.Results The patients with OYST were young(≤30 years old)and had large masses(maximum diameter 94~265 mm).The internal echo was mainly solid;the tumor was usually unilateral and regular in shape,and had abundant blood flow signal.There was often an abnormal increase of alpha-fetoprotein(>1000 ng/ml).All the ten OYST patients underwent surgical treatment,among which one died after surgery due to systemic tumor metastasis accompanied by pelvic abscess,one with pregnancy gave birth to a healthy baby,two having stageⅢA disease died,and two having stageⅢC and six with stageⅠC disease had disease-free survival,among which six had preserved fertility function and returned to normal menstruation within 3 months after chemotherapy,and six gave birth to healthy children.Conclusion OYST has some specific ultrasonic signs,and identification of its sonographic features combined with related clinical and laboratory examinations is of great importance for preoperative evaluation of this disease.