卵巢性索间质肿瘤的相关临床表现与超声特征分析

Analysis of related clinical manifestations and ultrasonic characteristics of ovarian sex cord stromal tumors

目的探讨卵巢性索间质肿瘤相关临床表现与超声特征。方法选取50例卵巢性索间质肿瘤患者,均予以超声检查,分析临床表现、检验异常及不同类型卵巢性索间质肿瘤的超声特征。结果50例患者均绝经,腹痛14例,腹部包块22例,泌尿症状17例,腹水4例,阴道出血13例;检验值异常包括糖类抗原125(CA125)异常10例,糖类抗原199(CA199)异常5例,人附睾蛋白4(HE4)异常3例。卵泡膜纤维瘤28例,形态规则、边界清晰、内部实性回声,后方回声多衰减,多无血流信号;纤维瘤10例,形态规则,边界多不清晰,实性内部回声,后方回声衰减,检出血流信号占比50%;卵泡膜细胞瘤4例,形态规则,边界清晰,实性内部回声,后方回声无变化或衰减,检出血流信号占比50%;纤维肉瘤4例,形态规则或不规则、边界清晰或不清晰,不规则囊实性内部回声,后方回声无变化或增强,有血流信号;颗粒细胞瘤4例形态规则,边界清晰,不规则囊实性回声,后方回声无变化,检出血流信号占比50%。结论卵巢性索间质肿瘤好发于绝经女性,部分肿瘤标志物水平异常,部分有较典型超声表现。

Objective To investigate the clinical manifestations and ultrasonic features of ovarian sex cord stromal tumors.Methods 50 cases of ovarian sex cord stromal tumors were examined by ultrasound to analyze the clinical manifestations,test abnormalities and ultrasonic characteristics of different types of ovarian sex cord stromal tumors.Results All the 50 patients were menopausal,with abdominal pain in 14 cases,abdominal mass in 22 cases,urinary symptoms in 17 cases,ascites in 4 cases,and vaginal bleeding in 13 cases,Abnormal test values included carbohydrate antigen 125(CA125)in 10 cases,carbohydrate antigen 199(CA199)in 5 cases,and human epididymis protein 4(HE4)in 3 cases.28 cases of follicular membrane fibroma showed regular shape,clear boundary,internal solid echo,most of the posterior echo attenuation,and no blood flow signal.There were 1o cases of fibroma,the shape was regular,the boundary was not clear,the solid internal echo,the rear echo attenuation,the detected blood flow signal accounted for 50%;There were 4 cases of follicular membrane cell tumor,regular shape,clear boundary,solid internal echo,no change or attenuation of the rear echo,the detected blood flow signal accounted for 50%;There were 4 cases of fibrosarcoma with regular or irregular shape,clear or unclear boundary,irregular cystic internal echo,no change or enhancement of posterior echo,and blood flow signal.The morphology of 4 cases of granulosa cell tumor was regular,the boundary was clear,the irregular cystic solid echo was not changed,and the blood flow signal accounted for 50%.Conclusion Ovarian sex cord stromal tumors are more common in postmenopausal women.Some tumor markers are abnormal and some have typical ultrasound findings.