卵巢卵泡膜–纤维瘤组(ovarian thecoma-fibroma groups, OTFG)肿瘤是一种罕见的性索间质来源肿瘤,通常为良性。临床上误诊率比较高,合并胸腹水或CA125升高时容易误诊为恶性肿瘤,肿瘤较大时与浆膜下肌瘤难以鉴别,术前的诊断影响治疗方...卵巢卵泡膜–纤维瘤组(ovarian thecoma-fibroma groups, OTFG)肿瘤是一种罕见的性索间质来源肿瘤,通常为良性。临床上误诊率比较高,合并胸腹水或CA125升高时容易误诊为恶性肿瘤,肿瘤较大时与浆膜下肌瘤难以鉴别,术前的诊断影响治疗方案的选择,尤其是对于育龄期女性,能否保留卵巢功能而选择肿瘤切除,因此进行准确的术前诊断对临床治疗和管理策略具有重要意义。超声仍然是对女性卵巢肿瘤术前的最常用的诊断方法。本文就超声对OTFG患者的术前诊断价值的相关研究进展展开综述。Ovarian thecoma-fibroma groups (OTFG) tumors are a rare sex cord-stromal derived tumor, which is usually benign. The misdiagnosis rate is relatively high clinically. When combined with pleural effusion or elevated CA125, it is easy to be misdiagnosed as a malignant tumor. When the tumor is large, it is difficult to distinguish it from subserosal fibroids. Preoperative diagnosis affects the choice of treatment options, especially for women of childbearing age. Whether the ovarian function can be preserved and tumor resection can be chosen, so accurate preoperative diagnosis is of great significance to clinical treatment and management strategies. Ultrasound is still the most commonly used preoperative diagnostic method for female ovarian tumors. This article reviews the research progress on the preoperative diagnostic value of ultrasound in patients with OTFG.展开更多
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。
文摘卵巢卵泡膜–纤维瘤组(ovarian thecoma-fibroma groups, OTFG)肿瘤是一种罕见的性索间质来源肿瘤,通常为良性。临床上误诊率比较高,合并胸腹水或CA125升高时容易误诊为恶性肿瘤,肿瘤较大时与浆膜下肌瘤难以鉴别,术前的诊断影响治疗方案的选择,尤其是对于育龄期女性,能否保留卵巢功能而选择肿瘤切除,因此进行准确的术前诊断对临床治疗和管理策略具有重要意义。超声仍然是对女性卵巢肿瘤术前的最常用的诊断方法。本文就超声对OTFG患者的术前诊断价值的相关研究进展展开综述。Ovarian thecoma-fibroma groups (OTFG) tumors are a rare sex cord-stromal derived tumor, which is usually benign. The misdiagnosis rate is relatively high clinically. When combined with pleural effusion or elevated CA125, it is easy to be misdiagnosed as a malignant tumor. When the tumor is large, it is difficult to distinguish it from subserosal fibroids. Preoperative diagnosis affects the choice of treatment options, especially for women of childbearing age. Whether the ovarian function can be preserved and tumor resection can be chosen, so accurate preoperative diagnosis is of great significance to clinical treatment and management strategies. Ultrasound is still the most commonly used preoperative diagnostic method for female ovarian tumors. This article reviews the research progress on the preoperative diagnostic value of ultrasound in patients with OTFG.
