Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions an...Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.展开更多
BACKGROUND Meigs’syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites,both of which resolve after removal of the tumor.Patients often seek treatment in the Department of Respirat...BACKGROUND Meigs’syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites,both of which resolve after removal of the tumor.Patients often seek treatment in the Department of Respiratory and Critical Care Medicine or other internal medicine departments due to symptoms caused by ascites or hydrothorax.Here,we report a rare case of Meigs'syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions.CASE SUMMARY A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath.Chest X-ray and chest computed tomography showed a modest volume of pleural fluid with pleural thickening in the right lung.The carbohydrate antigen 125(CA125)concentration was 150.8 U/mL(normal,0-35 U/mL)and no tumor cells were observed in pleural fluid.Nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a‘string of beads’-like appearance in the diaphragm were found by thoracoscopic examination.Furthermore,pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm×10.0 cm×12.4 cm with heterogeneous signal intensity and multiple hypointense separations.Total abdominal hysterectomy,bilateral adnexectomy,and separation of pelvic adhesion were performed under general anesthesia.The pathology results showed granulosa cell tumor.At the 2-mo follow-up after the surgery,the hydrothorax subsided,and the CA125 level returned to normal.CONCLUSION For postmenopausal women with unexplained hydrothorax and elevated CA125,in addition to being suspected of having gynecological malignancy,Meigs’syndrome should be considered.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Granulosa cell tumors belong to the group of stromal and sex cord tumors of the ovary. The adult type is the most co...<div style="text-align:justify;"> <span style="font-family:Verdana;">Granulosa cell tumors belong to the group of stromal and sex cord tumors of the ovary. The adult type is the most common type and usually occurs during the perimenopausal period while the juvenile type mostly affects young women. This is a report of a 26 years old woman who presented an adult type of granulosa cells tumor, with review of the literature. She complained abdominal pain and distension associated with abundant ascites and underwent a right adnexectomy. The pathology examination diagnosed an adult granulosa cell tumor. The two entities of granulosa cell tumors (juvenile and adult types) are distinguished by their characteristic morphological aspects on histological examination allowing diagnostic orientation.</span> </div>展开更多
Background: Granulosa cell tumors (GCTs) are rare neoplasms with a relatively favorable prognosis. They are characterized by a prolonged history and a tendency to late recurrences. It is the most common type of sex co...Background: Granulosa cell tumors (GCTs) are rare neoplasms with a relatively favorable prognosis. They are characterized by a prolonged history and a tendency to late recurrences. It is the most common type of sex cord-stromal tumors. Aims: To analyze, to report and to better understand the clinico-pathologic features and results of treatment, and prognostic factors of these tumors. Materials and Methods: A retrospective single-institutional review 17 cases of GCTs were treated in National Cancer Institute—Cairo University from January 2010 till December 2014. The clinical and pathological characteristics, treatment, and outcomes of patients with ovarian GCTs were analyzed. Results: Data from 17 patients were obtained. The median age was 54 years (range;14 - 72). Abdominal pain was the most common presentation (64.7%). The mean tumor size was 14 cm (range;7 - 23 cm). The majority of our patients were stage I (n = 11;64.7%), while (n = 3;17.6%) had stage III and (n = 2, 11.8%) were stage IV. Only one case (5.9%) had an unknown stage (explored outside NCI). The majority of cases were of adult type disease (n = 14) and low grade pathology (n = 10). In follow-up period (median = 42 months;ranging 9 - 60) three patients relapsed;the median overall survival time was not reached yet, however, the estimated 3-year survival was 72.5%. Conclusion: Granulosa cell tumors are rare neoplasms of the ovaries. They progress slowly and often are diagnosed in an early stage. Surgery is the main line of treatment. Prolonged post-therapeutic follow-up is necessary. Definition of proper prognostic factors is mandatory.展开更多
Introduction: Extraovarian granulosa cell tumor (GCT) is a very uncommon tumor, assumed to arise from the ectopic gonadal tissue along the embryonal route of the genital ridge. Case report: We report the case of a 25 ...Introduction: Extraovarian granulosa cell tumor (GCT) is a very uncommon tumor, assumed to arise from the ectopic gonadal tissue along the embryonal route of the genital ridge. Case report: We report the case of a 25 year-old woman who was presented at the emergency unit with a severe abdominal pain focused on the left iliac fossa. The patient had delivered normally 2 months before. An ovarian mass of 79 × 67 × 89 mm was shown in vaginal ultrasound as well as at the abdominal scan. Exploratory laparoscopy was performed and a torsion of the fallopian tube and an hemato-salpinges was visualized. Re-vascularisation was not achieved and a left salpingectomy took place. The immuno-histopathology report revealed an extra-ovarian GCT deriving from the fimbriae of the tube. Follow-up surgery was discussed. The case is presented for its rarity.展开更多
Objective:To retrospectively investigate the clinicopathological characteristics of ovarian juvenile granulosa cell tumors(JGCTs)and to evaluate the safety of fertility-sparing surgery.Methods:In this study,surgically...Objective:To retrospectively investigate the clinicopathological characteristics of ovarian juvenile granulosa cell tumors(JGCTs)and to evaluate the safety of fertility-sparing surgery.Methods:In this study,surgically treated patients with JGCTs diagnosed between January 2004 and October 2018 in our center were identified.Clinicopathological data,survival outcomes,and recurrence rates were examined in these patients.Results:A total of 8 patients were included.All patients were premenarchal girls or young women(age range,9-32 years).Irregular vaginal bleeding was the most common presenting symptom.Of them,seven patients were classified with Stage I JGCTs,and they underwent fertility-sparing surgery.One patient who had Stage IIIC JGCT and had completed childbearing underwent complete surgery.Seven patients received adjuvant chemotherapy.The median follow-up duration in the total cohort was 64 months(range,2-117 months).The overall survival rate in the fertility-sparing group was 100%,whereas the patient with Stage IIIC JGCT died 1 month after the treatment.Conclusions:Fertility-sparing surgery might not show a negative impact on oncologic outcomes.Fertility sparing could be considered a modified option for patients with Stage I JGCTs.However,due to the limited number of patients,the conclusion must be interpreted with caution,and larger or multicenter studies are needed before conclusions can be drawn.展开更多
Isosexual precocious puberty in girls has several etiologies. Juvenile granulose cell tumor is one of the rarest causes that only stands for 1.5% of ovarian cancers. This tumor mostly encounters in first 2 decades of ...Isosexual precocious puberty in girls has several etiologies. Juvenile granulose cell tumor is one of the rarest causes that only stands for 1.5% of ovarian cancers. This tumor mostly encounters in first 2 decades of life. This paper is a report of an 8-year-old girl with precocious puberty that within five months developed breast enlargement followed by menarche. Works which are done to find the underlying cause of precocious puberty revealed juvenile granulosa cell tumor in her left ovary. She then under went laparoscopic surgery and 3 courses of chemotherapy. She did not experience any vaginal bleeding after that and the serum level of estradiol lay among its normal ranges, but after that the tumor relapsed and presented as abdominal pain and a huge mass which under went resection of all afflicted tissues. After 2 courses of chemotherapy, her status deteriorated and unfortunately she died after 6 months from the time of diagnosis. Treatment for this disease is consists of resection surgery and chemotherapy. If this tumor is diagnosed in its early stages, it will be curable, but in its advanced stages, up to 80% of patients die from recurrent tumors. The reported patient was diagnosed at stage IIIC that had poor prognosis.展开更多
The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL)...The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL) in apoptosis of granulosa cells were explored. By using sodium prasterone sulfate rat PCOS model was induced. The apoptosis of granulosa cells in ovaries of rats was observed by TdT-mediated dUTP-biotin nick end-labeling (TUNEL), and the expression of TRAIL protein and mRNA in granulosa cells was detected by using immunhistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) respectively. The apoptotic rate and the expression of protein TRAIL in granulosa cells were significantly higher in antral follicles from the PCOS rats than in those from the control rats (P<0.01, P<0.05). There was no significant difference in apoptotic rate and the expression of TRAIL protein in granulosa cells of preantral follicles between the PCOS rats and the control rats (P>0.05). No apoptosis and the expression of TRAIL protein in granulosa cells of primordial follicles were found in the two groups. The expression of TRAIL mRNA was significantly stronger in granulosa cells from the PCOS rats than in those from the con- trol rats (P<0.01). It was suggested that the apoptotic rate in granulosa cells was significantly higher in antral follicle from the PCOS rats than in those from the control rats. TRAIL played a role in regu- lating the apoptosis of granulosa cells in PCOS rats.展开更多
Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors,...Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors, including granulosa cell tumors and other kinds of ovarian tumors, were monitored by serum INH RIA. Results: The mean value of serum INH contents in follicular, peri-ovulatory and mid-luteal phases of fertile women were 9.48±7.10 pg/ml (2.04～18.53pg/ml), 19.04±9.73 pg/ml (3.49～33.26 pg/ml) and 131.13±110.81 pg/ml (3.49～ 341.10 pg/ml), respectively. Serum INH concentration was negatively correlated with serum FSH concentration, (rs=?0.483,P<0.01). Serum IHN contents were less than 3.6 pg/ml in normal postmenopausal women. The mean value of serum INH contents in ovarian granulosa cell tumor, thecoma, mucinous cystadenocarcinoma and malignant teratoma cases were significantly higher than that of other ovarian tumors, (P<0.01). Serum INH contents were elevated in ovarian granulosa cell tumor, thecoma, mucinous cystadenocaricinoma and endometrioid carcinoma cases with serum CA-125 values in normal range before operation, but serum INH contents decreased to normal range within one week after operation. And consecutive serum INH RIA could be a valuable tool in monitoring for therapeutic effect. Conclusion: Modified INH RIA was of convenient, time-saving and quantitative characteristics, especially with its high sensitivity (<1 pg/ml). There was a regular change of serum INH concentrations during menstrual cycle. INH could inhibit the synthesis and secretion of follicle stimulating hormone (FSH). INH would become a valuable marker for ovarian tumor. INH RIA combined with the measurement of serum CA-125 would be helpful to the early diagnosis, treatment and follow-up for ovarian cancer.展开更多
Background: Ovarian sex cord-stromal tumors are an uncommon heterogeneous group of tumors with different biological behaviors and clinico-patho- logic aspects. Aim of the Work: This study will review the clinico-patho...Background: Ovarian sex cord-stromal tumors are an uncommon heterogeneous group of tumors with different biological behaviors and clinico-patho- logic aspects. Aim of the Work: This study will review the clinico-pathologic aspects of sex-cord stromal ovarian tumors at the National Cancer Institute (NCI), Cairo University, Egypt, as well as their management and follow-up regarding disease free survival and overall survival. Patients and Methods: This retrospective study was conducted at the National Cancer Institute Cairo University, Egypt on female patients with ovarian sex cord stromal tumors in the period from January 2008 to December 2012 with a follow-up period of 24 to 84 months. The age of the patients, different clinical presentations, radiological findings, associated uterine bleeding (need for endometrial biopsy), pre-operative CA125 levels, surgical management done, different histopathological types, different biological behaviors, presence of ascites (and its correlation with the histopathology), Adjuvant chemotherapy (according to biological behavior and pathological type), and follow-up of non-benign cases for up to 84 months will all be documented and studied. Results: The mean age at presentation was 47.34;abdominal pain and mass were the commonest presentations 54.5% and 53.2% respectively;the main radiologic findings were a pelvic mass +/- ascites which had no correlation to the pathological type (p = 0.075). Endometrial hyperplasia and endometrial carcinoma were associated with 22% and 2.5% of cases respectively. Stages I and II represented 95% of patients with non-benign tumors (48 patients). Panhysterectomy +/- infracolic omentectomy or fertility sparing surgery were done in 70.1% and 29.9% of patients respectively. AGCTs were the commonest pathological type (49.4%). Adjuvant chemotherapy was given to 14 patients (46.7%) with non-benign tumors. 6 recurrences (20%) in 30 patients with non-benign tumors on regular follow-up were documented. The median of disease free survival (DFS) was 50.5 months. The median overall survival was 49.5 months. Conclusion: Ovarian SCSTs are uncommon neoplasms with different biological behaviors where AGCTs are the commonest among Egyptian females. Hormonal manifestations are uncommon where abnormal vaginal bleeding is the commonest one. The presence of ascitic fluid has no correlation with the pathological type of the tumor. Early stages (I and II) represented about 95% of non-benign tumors. Surgical management without lymphadenectomy +/- adjuvant chemotherapy is the main line of treatment at our institute. The OS was shorter than that documented in the literature. A small number of patients, reluctance of follow-up and unavailability of some patients’ data were the main drawbacks in this study.展开更多
BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not we...BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not well?defined. CASE REPORT: A 69 year-old postmenopausal woman was admitted for metrorrhagia, a right ovary mass and?increasing pelvic pain. Preoperative clinical and instrumental examination suspected an ovarian tumor, and the?laparoscopic right ophorectomy and the frozen section suggested an ovarian SCST. To fast restore and preserve woman?integrity, total laparoscopic hysterectomy (TLH) plus left salpingo-ophorectomy (SO) were performed, without complications?in the short and long term follow-up. CONCLUSION: In the authors’ opinion, the minimally invasive management?of SCST by TLH plus bilateral SO followed by a prolonged surveillance and without intensive surgical staging,?could be an appropriate clinical and surgical choice in elder patient at early stage, since these tumors are slow at?growth, recurring locally and only a long time after initial treatment. We suggest, after a minimally invasive treatment,?a possible “wait and see” option, as in our case report.展开更多
文摘Polycystic ovary syndrome (PCOS) is a major cause of anovulatory infertility. Laparoscopic ovarian drilling (LOD) is a treatment for PCOS that allows the laparoscopic identification of other intra-abdominal lesions and the provision of diagnostic treatment. This study reports a case of PCOS with an ovarian mass in which LOD was aggressively used and a granulosa cell tumor (GCT) was found. A 34-year-old woman with secondary amenorrhea and irregular menstrual cycles presented to the emergency department with abdominal pain of unknown etiology. Imaging studies revealed a 6-cm left ovarian mass with an internal appearance suggestive of a hemorrhage. The patient’s secondary amenorrhea was subsequently diagnosed as PCOS, and LOD was performed to preserve her fertility. Simultaneously, a cystectomy was performed to evaluate the tumor in the left ovary;the diagnosis was adult-type GCT. Although concomitant GCT and PCOS are extremely rare, the two conditions have similar clinical manifestations. In women of reproductive age, the impact of surgery on future fertility should be considered, and the initial surgical technique should be chosen carefully.
基金Supported by the Scientific Research Project of Sichuan Provincial Health and Family Planning Commission,No.18PJ409.
文摘BACKGROUND Meigs’syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites,both of which resolve after removal of the tumor.Patients often seek treatment in the Department of Respiratory and Critical Care Medicine or other internal medicine departments due to symptoms caused by ascites or hydrothorax.Here,we report a rare case of Meigs'syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions.CASE SUMMARY A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath.Chest X-ray and chest computed tomography showed a modest volume of pleural fluid with pleural thickening in the right lung.The carbohydrate antigen 125(CA125)concentration was 150.8 U/mL(normal,0-35 U/mL)and no tumor cells were observed in pleural fluid.Nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a‘string of beads’-like appearance in the diaphragm were found by thoracoscopic examination.Furthermore,pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm×10.0 cm×12.4 cm with heterogeneous signal intensity and multiple hypointense separations.Total abdominal hysterectomy,bilateral adnexectomy,and separation of pelvic adhesion were performed under general anesthesia.The pathology results showed granulosa cell tumor.At the 2-mo follow-up after the surgery,the hydrothorax subsided,and the CA125 level returned to normal.CONCLUSION For postmenopausal women with unexplained hydrothorax and elevated CA125,in addition to being suspected of having gynecological malignancy,Meigs’syndrome should be considered.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Granulosa cell tumors belong to the group of stromal and sex cord tumors of the ovary. The adult type is the most common type and usually occurs during the perimenopausal period while the juvenile type mostly affects young women. This is a report of a 26 years old woman who presented an adult type of granulosa cells tumor, with review of the literature. She complained abdominal pain and distension associated with abundant ascites and underwent a right adnexectomy. The pathology examination diagnosed an adult granulosa cell tumor. The two entities of granulosa cell tumors (juvenile and adult types) are distinguished by their characteristic morphological aspects on histological examination allowing diagnostic orientation.</span> </div>
文摘Background: Granulosa cell tumors (GCTs) are rare neoplasms with a relatively favorable prognosis. They are characterized by a prolonged history and a tendency to late recurrences. It is the most common type of sex cord-stromal tumors. Aims: To analyze, to report and to better understand the clinico-pathologic features and results of treatment, and prognostic factors of these tumors. Materials and Methods: A retrospective single-institutional review 17 cases of GCTs were treated in National Cancer Institute—Cairo University from January 2010 till December 2014. The clinical and pathological characteristics, treatment, and outcomes of patients with ovarian GCTs were analyzed. Results: Data from 17 patients were obtained. The median age was 54 years (range;14 - 72). Abdominal pain was the most common presentation (64.7%). The mean tumor size was 14 cm (range;7 - 23 cm). The majority of our patients were stage I (n = 11;64.7%), while (n = 3;17.6%) had stage III and (n = 2, 11.8%) were stage IV. Only one case (5.9%) had an unknown stage (explored outside NCI). The majority of cases were of adult type disease (n = 14) and low grade pathology (n = 10). In follow-up period (median = 42 months;ranging 9 - 60) three patients relapsed;the median overall survival time was not reached yet, however, the estimated 3-year survival was 72.5%. Conclusion: Granulosa cell tumors are rare neoplasms of the ovaries. They progress slowly and often are diagnosed in an early stage. Surgery is the main line of treatment. Prolonged post-therapeutic follow-up is necessary. Definition of proper prognostic factors is mandatory.
文摘Introduction: Extraovarian granulosa cell tumor (GCT) is a very uncommon tumor, assumed to arise from the ectopic gonadal tissue along the embryonal route of the genital ridge. Case report: We report the case of a 25 year-old woman who was presented at the emergency unit with a severe abdominal pain focused on the left iliac fossa. The patient had delivered normally 2 months before. An ovarian mass of 79 × 67 × 89 mm was shown in vaginal ultrasound as well as at the abdominal scan. Exploratory laparoscopy was performed and a torsion of the fallopian tube and an hemato-salpinges was visualized. Re-vascularisation was not achieved and a left salpingectomy took place. The immuno-histopathology report revealed an extra-ovarian GCT deriving from the fimbriae of the tube. Follow-up surgery was discussed. The case is presented for its rarity.
文摘Objective:To retrospectively investigate the clinicopathological characteristics of ovarian juvenile granulosa cell tumors(JGCTs)and to evaluate the safety of fertility-sparing surgery.Methods:In this study,surgically treated patients with JGCTs diagnosed between January 2004 and October 2018 in our center were identified.Clinicopathological data,survival outcomes,and recurrence rates were examined in these patients.Results:A total of 8 patients were included.All patients were premenarchal girls or young women(age range,9-32 years).Irregular vaginal bleeding was the most common presenting symptom.Of them,seven patients were classified with Stage I JGCTs,and they underwent fertility-sparing surgery.One patient who had Stage IIIC JGCT and had completed childbearing underwent complete surgery.Seven patients received adjuvant chemotherapy.The median follow-up duration in the total cohort was 64 months(range,2-117 months).The overall survival rate in the fertility-sparing group was 100%,whereas the patient with Stage IIIC JGCT died 1 month after the treatment.Conclusions:Fertility-sparing surgery might not show a negative impact on oncologic outcomes.Fertility sparing could be considered a modified option for patients with Stage I JGCTs.However,due to the limited number of patients,the conclusion must be interpreted with caution,and larger or multicenter studies are needed before conclusions can be drawn.
文摘Isosexual precocious puberty in girls has several etiologies. Juvenile granulose cell tumor is one of the rarest causes that only stands for 1.5% of ovarian cancers. This tumor mostly encounters in first 2 decades of life. This paper is a report of an 8-year-old girl with precocious puberty that within five months developed breast enlargement followed by menarche. Works which are done to find the underlying cause of precocious puberty revealed juvenile granulosa cell tumor in her left ovary. She then under went laparoscopic surgery and 3 courses of chemotherapy. She did not experience any vaginal bleeding after that and the serum level of estradiol lay among its normal ranges, but after that the tumor relapsed and presented as abdominal pain and a huge mass which under went resection of all afflicted tissues. After 2 courses of chemotherapy, her status deteriorated and unfortunately she died after 6 months from the time of diagnosis. Treatment for this disease is consists of resection surgery and chemotherapy. If this tumor is diagnosed in its early stages, it will be curable, but in its advanced stages, up to 80% of patients die from recurrent tumors. The reported patient was diagnosed at stage IIIC that had poor prognosis.
文摘The relationship between apoptosis of granulosa cells and follicle development arrest in polycystic ovarian syndrome (PCOS) rats, and the contribution of tumor necrosis factor related apoptosis inducing ligand (TRAIL) in apoptosis of granulosa cells were explored. By using sodium prasterone sulfate rat PCOS model was induced. The apoptosis of granulosa cells in ovaries of rats was observed by TdT-mediated dUTP-biotin nick end-labeling (TUNEL), and the expression of TRAIL protein and mRNA in granulosa cells was detected by using immunhistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) respectively. The apoptotic rate and the expression of protein TRAIL in granulosa cells were significantly higher in antral follicles from the PCOS rats than in those from the control rats (P<0.01, P<0.05). There was no significant difference in apoptotic rate and the expression of TRAIL protein in granulosa cells of preantral follicles between the PCOS rats and the control rats (P>0.05). No apoptosis and the expression of TRAIL protein in granulosa cells of primordial follicles were found in the two groups. The expression of TRAIL mRNA was significantly stronger in granulosa cells from the PCOS rats than in those from the con- trol rats (P<0.01). It was suggested that the apoptotic rate in granulosa cells was significantly higher in antral follicle from the PCOS rats than in those from the control rats. TRAIL played a role in regu- lating the apoptosis of granulosa cells in PCOS rats.
文摘目的:卵巢粒层细胞瘤(ovary granulosa cell tumor,OGCT)与纤维卵泡膜细胞瘤(ovarian fibrothecoma,OF)是卵巢性索间质肿瘤较为常见的类型。由于二者均含有卵泡膜细胞且OGCT呈弥漫性生长模式时与富于细胞的OF和黄素化的OF组织学形态具有相似性,造成二者在病理诊断过程中鉴别困难。本文旨在通过探究OGCT与OF蛋白质组学差异、筛选二者间差异表达蛋白质(differentially expressed proteins,DEPs),发现鉴别诊断二者的生物学标志物。方法:选取5例OGCT和5例OF患者的新鲜肿瘤样本组织,采用蛋白质消化、肽段纯化技术及液相色谱-质谱/质谱分析进行蛋白质定量。运用软件对OGCT和OF的蛋白质进行DEPs分析;对DEPs进行基因本体(gene ontology,GO)和京都基因和基因组数据库(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析,并在生物过程(bioprocess,BP)、分子功能(molecular function,MF)和细胞组分(cell component,CC)方面对蛋白质/基因进行功能注释,探讨DEPs显著富集的信号通路;通过检索基因/蛋白质相互作用(search tool for the retrieval of interacting genes/proteins,STRING)数据库获得筛选出的DEPs相互作用信息,构建蛋白质-蛋白质相互作用(protein-protein interaction,PPI)网络。选取26例OGCT和28例OF石蜡包埋组织,通过组织芯片技术和免疫组织化学染色法验证筛选出的DEPs在OGCT和OF中的表达情况。结果:共筛选出24个OGCT与OF显著DEPs,其中13个蛋白质在OGCT中表达量显著上调,11个蛋白质在OF中表达量显著上调。GO富集分析结果显示:富集到BP上的通路包括细胞外基质(extracellular matrix,ECM)处理过程,细胞外结构组织,有机酸、羧酸、脂肪酸和单羧酸分解代谢过程;富集到CC上的通路包括含胶原蛋白的ECM、内质网腔和线粒体基质;富集到MF上的通路包括硫化物结合、ECM结构成分、酰胺结合、胶原结合、转移酶活性和转移酰基。KEGG富集分析结果显示:上调的DEPs主要富集于缬氨酸、亮氨酸和异亮氨酸降解途径;下调的DEPs主要富集于先天性谷胱甘肽代谢缺陷症、朊病毒疾病、花生四烯酸代谢途径、补体系统、细胞色素P450对异种生物的代谢作用和药物代谢-细胞色素P450。PPI结果显示24个DEPs与多种蛋白质存在相互作用关系。组织芯片免疫组织化学染色显示:PLOD3在OGCT中高表达,在OF中低表达,与富集分析结果一致。结论:通过蛋白质组学技术和生物信息学分析方法共筛选出24个DEPs,经免疫组织化学验证,PLOD3在OGCT与OF鉴别诊断中具有一定的临床应用价值,有望成为OGCT与OF鉴别诊断的生物学标志物。
文摘Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors, including granulosa cell tumors and other kinds of ovarian tumors, were monitored by serum INH RIA. Results: The mean value of serum INH contents in follicular, peri-ovulatory and mid-luteal phases of fertile women were 9.48±7.10 pg/ml (2.04～18.53pg/ml), 19.04±9.73 pg/ml (3.49～33.26 pg/ml) and 131.13±110.81 pg/ml (3.49～ 341.10 pg/ml), respectively. Serum INH concentration was negatively correlated with serum FSH concentration, (rs=?0.483,P<0.01). Serum IHN contents were less than 3.6 pg/ml in normal postmenopausal women. The mean value of serum INH contents in ovarian granulosa cell tumor, thecoma, mucinous cystadenocarcinoma and malignant teratoma cases were significantly higher than that of other ovarian tumors, (P<0.01). Serum INH contents were elevated in ovarian granulosa cell tumor, thecoma, mucinous cystadenocaricinoma and endometrioid carcinoma cases with serum CA-125 values in normal range before operation, but serum INH contents decreased to normal range within one week after operation. And consecutive serum INH RIA could be a valuable tool in monitoring for therapeutic effect. Conclusion: Modified INH RIA was of convenient, time-saving and quantitative characteristics, especially with its high sensitivity (<1 pg/ml). There was a regular change of serum INH concentrations during menstrual cycle. INH could inhibit the synthesis and secretion of follicle stimulating hormone (FSH). INH would become a valuable marker for ovarian tumor. INH RIA combined with the measurement of serum CA-125 would be helpful to the early diagnosis, treatment and follow-up for ovarian cancer.
文摘Background: Ovarian sex cord-stromal tumors are an uncommon heterogeneous group of tumors with different biological behaviors and clinico-patho- logic aspects. Aim of the Work: This study will review the clinico-pathologic aspects of sex-cord stromal ovarian tumors at the National Cancer Institute (NCI), Cairo University, Egypt, as well as their management and follow-up regarding disease free survival and overall survival. Patients and Methods: This retrospective study was conducted at the National Cancer Institute Cairo University, Egypt on female patients with ovarian sex cord stromal tumors in the period from January 2008 to December 2012 with a follow-up period of 24 to 84 months. The age of the patients, different clinical presentations, radiological findings, associated uterine bleeding (need for endometrial biopsy), pre-operative CA125 levels, surgical management done, different histopathological types, different biological behaviors, presence of ascites (and its correlation with the histopathology), Adjuvant chemotherapy (according to biological behavior and pathological type), and follow-up of non-benign cases for up to 84 months will all be documented and studied. Results: The mean age at presentation was 47.34;abdominal pain and mass were the commonest presentations 54.5% and 53.2% respectively;the main radiologic findings were a pelvic mass +/- ascites which had no correlation to the pathological type (p = 0.075). Endometrial hyperplasia and endometrial carcinoma were associated with 22% and 2.5% of cases respectively. Stages I and II represented 95% of patients with non-benign tumors (48 patients). Panhysterectomy +/- infracolic omentectomy or fertility sparing surgery were done in 70.1% and 29.9% of patients respectively. AGCTs were the commonest pathological type (49.4%). Adjuvant chemotherapy was given to 14 patients (46.7%) with non-benign tumors. 6 recurrences (20%) in 30 patients with non-benign tumors on regular follow-up were documented. The median of disease free survival (DFS) was 50.5 months. The median overall survival was 49.5 months. Conclusion: Ovarian SCSTs are uncommon neoplasms with different biological behaviors where AGCTs are the commonest among Egyptian females. Hormonal manifestations are uncommon where abnormal vaginal bleeding is the commonest one. The presence of ascitic fluid has no correlation with the pathological type of the tumor. Early stages (I and II) represented about 95% of non-benign tumors. Surgical management without lymphadenectomy +/- adjuvant chemotherapy is the main line of treatment at our institute. The OS was shorter than that documented in the literature. A small number of patients, reluctance of follow-up and unavailability of some patients’ data were the main drawbacks in this study.
文摘BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not well?defined. CASE REPORT: A 69 year-old postmenopausal woman was admitted for metrorrhagia, a right ovary mass and?increasing pelvic pain. Preoperative clinical and instrumental examination suspected an ovarian tumor, and the?laparoscopic right ophorectomy and the frozen section suggested an ovarian SCST. To fast restore and preserve woman?integrity, total laparoscopic hysterectomy (TLH) plus left salpingo-ophorectomy (SO) were performed, without complications?in the short and long term follow-up. CONCLUSION: In the authors’ opinion, the minimally invasive management?of SCST by TLH plus bilateral SO followed by a prolonged surveillance and without intensive surgical staging,?could be an appropriate clinical and surgical choice in elder patient at early stage, since these tumors are slow at?growth, recurring locally and only a long time after initial treatment. We suggest, after a minimally invasive treatment,?a possible “wait and see” option, as in our case report.
