Ovarian Sex Cord-Stromal Tumors in Postmenopausal Women and Total Laparoscopical Management

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.

Ovarian endometrioid carcinoma resembling sex cord-stromal tumor:A case report

BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor(ECSCSs)is rare.CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary.A 39-year-old female patient had persistent dull pain in the lower abdomen for more than 1 mo,and she was initially diagnosed with pelvic inflammatory disease at a hospital.The patient received transabdominal hysterectomy,bilateral salpingo-oophorectomy,and pelvic and para-aortic lymph node dissection at our hospital and finally diagnosed with ECSCSs.After the operation,the patient received eight courses of cisplatinum+etoposide+bleomycin chemotherapy treatment and no evidence of tumor recurrence or metastasis was found in a 2-year follow-up period.CONCLUSION Ovarian endometrioid carcinoma is similar to the ovary sex cord-stromal tumor,especially when the cord-like structure is obvious.The clinical diagnosis for this tumor is difficult before surgery and pathology examination.The necessary immunohistochemical markers are of positive significance for assisting diagnosis and differential diagnosis.

A Retrospective Study of Ovarian Sex Cord Stromal Tumors at the Egyptian National Cancer Institute

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.

Gynecological tumors in patients with Peutz-Jeghers syndrome (PJS)

Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the development of hamartomatous polyposis in the gastrointestinal tract and melanin-pigmented macules on the skin mucosa. The responsible gene is a tumor suppressor, STK11/LKB1, on chromosome 19p13.3. PJS complicates with benign and malignant tumors in various organs. In gynecology, there has been a particular focus on complications of PJS with sex cord tumor with annular tubules (SCTAT) and minimal deviation adenocarcinoma (MDA), which are rare diseases. Approximately 36% of patients with SCTAT are complicated with PJS and these patients are characterized by multifocal, bilateral, small and benign lesions that develop into tumors with mucinous to serous ratios of 8:1. In addition, 10% of cases of MDA are complicated with PJS and mutation of STK11, the gene responsible for PJS, has a major effect on onset and prognosis. The disease concept of lobular endocervical glandular hyper-plasia (LEGH) has recently been proposed and LEGH is thought to be a potential premalignant lesion of MDA, however, the relationship between PJS and LEGH remains unclear. Several case reports of PJS patients complicated with gynecological tumors have been published and further studies are needed to determine the underlying

Uterine tumor resembling an ovarian sex cord tumor:A case report and review of literature

BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors.Here,we report a case of UTROSCT in a 51-year-old woman.CASE SUMMARY A 51-year-old woman had irregular menses for 6 mo.The patient visited a local hospital for vaginal bleeding.Pelvic computed tomography(CT)showed a mass in the pelvic cavity.Five days later,she came to our hospital for further diagnosis.The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor.She then underwent total removal of the uterus with bilateral salpingectomy.Postoperative histological examination showed that the tumor cells had abundant cytoplasm,ovoid and spindle-shaped nuclei,fine chromatin,a high nucleoplasm ratio,and a lamellar distribution.The findings were consistent with UTROSCT,and the results of immunohistochemical analysis supported that diagnosis.The tumor was International Federation of Gynecology and Obstetrics stage IB.No adjuvant therapy was administered after radical surgery.The patient was followed up for 58 mo,and no recurrence was found.CONCLUSION We report a case of UTROSCT with abnormal menstruation as a symptom,which is one of the most common symptoms.In patients with vaginal bleeding,ultrasonography can be used as a screening test because of its convenience,speed,and lack of radiation exposure.For patients with long-term tamoxifen use,routine monitoring of the endometrium is recommended.As UTROSCT may have low malignant potential,surgery remains the primary management strategy.Additionally,fertility preservation in patients of childbearing age is a vital consideration.

Effect of Guizhi Fuling Capsule on sex hormone level and tumor markers in patients with uterine fibroids

Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroids who were treated in our hospital from August 2016 to August 2017 were selected according to the order of treatment and divided into observation group and control group, 60 cases each. Mifepristone was administered to the control group and mifepristone combined with Guizhi Fuling Capsules was administered to the observation group. The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups.Result:The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups. After treatment, hemoglobin levels increased significantly in the two groups, VEGF, sex hormones FSH, LH and E2, tumor markers HE4, CA125, inflammatory cytokines TNF-α and IFN-γ levels decreased significantly. The hemoglobin level of the observation group was (117.09±11.51) g/L higher than that of the control group , and the level of VEGF was (0.69±0.06) pg/mL lower than that of the control group. The levels of sex hormone FSH, LH and E2 in the observation group were (15.87±1.56) U/L, (10.69±1.06) U/L and (4.95±0.51) pmol/L lower than those of the control group. The levels of HE4, CA125, TNF-α and IFN-γ gamma in the observation group were (52.47±5.24) pmol/L, (15.46±1.53) U/mL, (40.41±4.05) and (16.72±1.62) pg/mL lower than those of the control group.Conclusion:Guizhi Fuling Capsule can significantly improve the level of sex hormones and tumor markers, relieve inflammatory stress and improve the therapeutic effect.

Serous cystadenoma with co-existing stromal tumor with sex-cord stromal elements: An extremely rare tumor

Surface epithelial-stromal tumors are the most common neoplasm of ovary in the reproductive age and beyond. Less than 1% of epithelial ovarian tumors occur before the age of 21 years while 75% of sexcord stromal tumors (Sertoli and Leydig Cell) occur in the third and fourth decades of life. Serous tumors rarely occur in combination with germ cell tumors, sex-cord stromal tumors or granulosa cell tumors. Thus it is extremely rare for a combination of the above two tumors to occur before 21 years although a case report for a tumor with epithelial, stromal and sex-cord stromal elements for a 58-year-old patient has been documented. We believe ours is the first case in literature of a massive Serous Cystadenoma with co-existing stromal tumor with minor sex-cord stromal (Sertoli-Leydig Cell) elements.

Sclerosing stromal tumor of the ovary with masculinization,Meig’s syndrome and CA125 elevation in an adolescent girl:A case report

BACKGROUND Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of theovary. It was first reported and named in 1973. These tumors typically presentwith pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses,but rarely present with masculinity in children and adolescents. Only 2 cases ofthese tumors have been reported in premenarchal girls, who demonstratedhormonal activity, with a history of the development of a virilizing female due tohyperandrogenism. Here, we report a case of a giant SST with obviousmasculinity combined with Meig’s syndrome and CA125 elevation.CASE SUMMARY A 17-year-old female presented with a 7-year history of the development ofmasculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obviouslaryngeal prominence, and voice deepening. Physical examination showed a malesuprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory testsshowed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3ng/mL). A computed tomography scan of the abdomen and pelvis was carriedout and showed a large, solid and cystic, partly calcified pelvic mass in the rightovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to thelevel of the upper part of L1). Intraoperative findings at laparotomy revealed alarge tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy wasperformed. Microscopic examination and immunohistochemical staining of thesurgical specimen showed an SST of the ovary.CONCLUSION This report is remarkable as our patient was not only diagnosed with an SST ofthe ovary, which is extremely rare in this age group, but was the largest and mostobvious reported patient with this tumor who presented with virilization.Therefore, gynecologists should be aware of this potential complication inadolescent girls with a mass in the ovary.

Retiform Sertoli-Leydig Cell Tumor of the Ovary

Sertoli-Leydig cell tumor of the ovary is a kind of sex cord-stromal tumor, which occurs between teens and twenties with symptoms including abdominal pain and swelling. The incidence rate is infinitely rare comprising less than 0.5% of all ovarian tumor. The average age of “retiform Sertoli-Leydig cell tumor” is 17 years as compared to 25 years for Sertoli-Leydig cell tumors as a group. We have experienced this rare case of retiform Sertoli-Leydig cell tumor in a 25-year-old foreign patient with the complaint of palpable mass on the right lower quadrant and an irregular menstrual period. The patient underwent right salpingo-oophorectomy and tumor stage was FIGO stage 1A. We report with a brief review of literature.

Adult Granulosa Cell Tumor in a Young Woman: A Case Report and Literature Review

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.

α-抑制素联合网状纤维双重染色在卵巢性索-间质肿瘤诊断中的应用

目的卵巢性索-间质肿瘤(sexcord-stromal tumor,SCST)是一类罕见的原发性卵巢肿瘤,种类多样且形态各异。免疫组织化学染色和网状纤维特殊染色在辅助诊断中具有重要作用。然而,单独使用免疫组织化学染色或特殊染色在识别肿瘤细胞时往往既费时又费力,导致诊断困难。本研究旨在通过联合染色技术提高诊断的效率和准确性。方法本研究采用免疫组织化学染色与网状纤维染色的联合应用,以帮助诊断SCST。为了获得更佳的染色效果,我们使用免疫组织化学红染法替代传统的显色方法。结果在采用双重染色法的标本中,免疫组织化学阳性的肿瘤细胞显示为红色,而网状纤维则呈现黑色,两者色彩鲜明且对比明显。结论在卵巢性索-间质肿瘤的诊断中,使用免疫组织化学红染法结合网状纤维双重染色可以清晰地揭示网状纤维与肿瘤组织之间的关系,直观展示肿瘤细胞的类型及其分布。这种方法有助于提高诊断的准确性,值得在临床上推广应用。

类似卵巢性索肿瘤的子宫肿瘤4例及其临床病理特征

目的:类似卵巢性索肿瘤的子宫肿瘤(uterine tumor resembling ovarian sex cord tumor,UTROSCT)是发生于子宫体的罕见肿瘤。本研究旨在探讨UTROSCT的临床病理特点、诊断及鉴别诊断。方法:回顾性分析郑州大学第三附属医院2020年1月至2023年6月诊治的4例UTROSCT患者的临床病理资料、免疫组织化学及荧光原位杂交等检查结果,总结其病变特点。结果:4例患者年龄为44~59(中位数46.5)岁,3例因月经异常就诊,1例为体检发现。肿瘤直径为3.0~5.0(中位数4.1)cm,3例肿瘤位于黏膜下,1例位于肌壁间。彩色多普勒超声检查均提示不均质低回声,2例行宫腔镜下黏膜肌瘤电切术,1例行腹腔镜下全子宫加双侧输卵管切除术,1例行腹腔镜下全子宫加双附件切除术。4例患者随访2~42(中位数33.5)个月,均未见复发及转移。显微镜下肿瘤细胞呈片状、巢状、小梁状和条索状排列,3例肿瘤细胞由上皮样细胞构成,细胞中等大小,细胞质中等或稀少,部分细胞质透亮,1例肿瘤细胞由上皮样细胞和泡沫样细胞构成,其中泡沫样细胞大小较一致,胞质丰富,2种肿瘤细胞核呈圆形或卵圆形,染色质较细,可见核仁。4例肿瘤细胞均形态温和,未见明确坏死、脉管内瘤栓及病理性核分裂象。免疫组织化学显示肿瘤细胞表达波形蛋白(vimentin)(4/4)、细胞角蛋白(cytokeratins,CK)(3/4)、雌激素受体(estrogen receptor,ER)(4/4)、孕激素受体(progesterone receptor,PR)(4/4)、白细胞分化抗原10(cluster of differentiation 10,CD10)(3/4),并且至少表达2种以上性索源性标志[钙网蛋白(calretinin)(3/4)、类固醇生成因子-1(steroidogenic factor-1,SF-1)(2/4)、白细胞分化抗原99(cluster of differentiation 99,CD99)(4/4)、神经细胞黏附分子(cluster of differentiation 56,CD56)(4/4)、α-抑制素(α-inhibin)(2/4)、肾母细胞瘤基因1(Wilms’tumor gene 1,WT-1)(3/4)]。4例肿瘤细胞均表达肌源性标志平滑肌肌动蛋白(smooth muscle actin,SMA)(4/4)及结蛋白(desmin)(4/4),均不表达上皮膜抗原(epithelial membrane antigen,EMA)(0/4),增殖指数Ki-67为5%~10%。荧光原位杂交检测结果显示病例3和病例4 NCOA3基因断裂(2/4),病例1和病例2未见断裂;病例2未见JAZF1基因断裂(0/1)。结论:UTROSCT是一种非常罕见的子宫肿瘤,常见于中年女性,具有低度恶性倾向,彩色多普勒超声检查表现为不均质低回声,组织学形态、免疫组织化学及分子改变相结合有助于其诊断与鉴别诊断。

类似卵巢性索肿瘤的子宫肿瘤的临床病理分析

目的探讨类似卵巢性索肿瘤的子宫肿瘤(UTROSCT)的临床、病理特征以及相关基因组学变化,以期更好地了解其性质,有助于精确的治疗和预测患者的预后。方法通过对10例患者做UTROSCT镜检及免疫组化分析,对患者进行随访,并查阅相关文献。结果患者平均年龄48岁,范围为26~69岁。肿瘤直径0.5~8 cm,切面多为灰白、灰黄色。首发症状常为经期紊乱或异常阴道出血,肿瘤位于黏膜下或者肌间多见。10例患者均预后良好,无病生存,随访时间2~125个月。镜检:肿瘤可多种方式排列,如条索、巢状、小管样、网状或小梁状,间质常可见玻璃样变。细胞呈圆形或卵圆形,核仁较常见,偶见核分裂象。免疫表型:肿瘤多向分化,10例肿瘤性索分化的标记均有不同程度表达,大部分表达平滑肌、上皮标记,ER、PR和CD10也常为阳性。结论UTROSCT是一种多表型且少见的肿瘤,临床特征无特异性,预后一般较好,也可转移复发。目前主要依靠组织病理结合免疫组化,分子病理是明确诊断及判断患者预后的重要手段。治疗方式主要为手术切除。

MRI鉴别诊断卵巢颗粒细胞瘤与卵泡膜纤维瘤

目的观察MRI鉴别诊断卵巢颗粒细胞瘤(OGCT)与卵泡膜纤维瘤(OTF)的价值。方法回顾性分析37例OGCT(OGCT组)与74例OTF(OTF组)女性,比较其MRI参数;行多因素logistic回归分析,观察各参数单独及联合鉴别诊断OGCT与OTF的效能。结果组间病灶囊实性分型,囊变程度、囊区最大径,实性部分T2WI信号、强化程度、表观弥散系数(ADC),以及是否合并蜂窝征/奶酪征、有无肿瘤内血管及出血差异均有统计学意义(P均<0.05)。其中,囊变程度、ADC及是否合并蜂窝征/奶酪征为MRI鉴别OGCT与OTF的影响因素,其鉴别OGCT与OTF的曲线下面积(AUC)分别为0.834、0.868及0.744,而三者联合的AUC为0.934,大于其单一AUC(P均<0.05)。结论病灶囊变程度、实性部分ADC及是否合并蜂窝征/奶酪征等MRI特征有助于鉴别OGCT与OTF。

多样性腭部疾病数据的临床预判关键点

目的研究多样性腭部疾病数据的临床预判关键点。方法共纳入335例腭部疾病患者,来源于河北医科大学第二医院(n=245)与西南医科大学附属医院(n=90)。根据性别、年龄、发病部位、病理类型和组织学来源等抽取数据,依次分组,探讨腭部疾病关联各参数后的类型及特征分布,找到腭部疾病多样性临床预判的指导性关键点。结果腭部恶性肿瘤好发于男性,以口腔黏膜上皮源性肿瘤为主,鳞癌最多;良性肿瘤好发于女性,以唾液腺上皮源性肿瘤为主,多形性腺瘤最多。腭部疾病好发年龄区间为41~60岁,其中腭部良性肿瘤好发年龄区间为61~80岁,腭部恶性肿瘤好发年龄区间为21~60岁。腭部囊肿好发于硬腭,而其他腭部疾病均在软硬腭交界区高发。腭部良性肿瘤组织病理学以唾液腺上皮源性肿瘤来源为主,而腭部恶性肿瘤则以口腔黏膜上皮源性肿瘤来源为主。结论通过腭部疾病关联性别比例、年龄区间、好发区域、病理类型,寻找到多样性腭部疾病的临床预判关键点,进而预判腭部疾病方向,降低误诊率,为患者争取最佳治疗时机,提高患者的生存预后。

妊娠期糖尿病患者孕6~14周血清CTRP3、FGF19及SHBG的变化及预测价值

目的探讨妊娠期糖尿病(GDM)患者孕6~14周血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、成纤维细胞生长因子19(FGF19)及性激素结合球蛋白(SHBG)的变化及预测价值。方法回顾性分析2019年6月至2022年10月在秦皇岛市第一医院分娩的684例单胎妊娠孕妇的临床资料。统计GDM发生率,根据是否患有GDM分为病例组(n=266)和对照组(n=418)。比较两组CTRP3、FGF19及SHBG水平,并分析其联合预测GDM的价值,采用单因素和多因素Logistic回归分析影响GDM发生的危险因素。结果684例孕妇GDM发生率为38.89%(266/684)。与对照组比较,病例组CTRP3、FGF19及SHBG水平更低(P<0.05)。受试者工作特征(ROC)曲线结果显示,CTRP3、FGF19及SHBG联合预测GDM的曲线下面积(AUC)高于单项预测(P<0.05)。两组年龄、孕前体重指数(BMI)、不良孕产史、糖尿病家族史、妊娠期高血压、月经周期紊乱、CTRP3、FGF19、SHBG比较,差异具有统计学意义(P<0.05);两组孕次、产次比较,差异无统计学意义(P>0.05)。年龄≥35岁、孕前BMI≥24 kg/m^(2)、不良孕产史、糖尿病家族史、CTRP3<417.82 ng/L、FGF19<139.23 pg/mL、SHBG<429.59 mmol/L是影响GDM发生的独立危险因素(P<0.05)。结论GDM患者孕6~14周CTRP3、FGF19及SHBG水平均会下降,通过CTRP3、FGF19及SHBG联合预测GDM具有较高的应用价值。

地屈孕酮、甲羟孕酮在早期子宫内膜癌宫腔镜电切术后患者中的应用

目的:探究及比较地屈孕酮、甲羟孕酮在早期子宫内膜癌患者宫腔镜电切术后的应用效果及对肿瘤标志物、性激素的影响。方法:将2020年1月—2021年6月泉州东南医院的80例早期子宫内膜癌拟行宫腔镜电切术患者根据随机数字表法分为A组(40例)和B组(40例)。A组采用地屈孕酮进行治疗,B组则采用甲羟孕酮进行治疗。比较两组的治疗总有效率、不良反应发生率、术后不同时间的复发率、肿瘤标志物[血清糖类抗原125(CA125)、糖类抗原19-9(CA19-9)及人附睾蛋白4(HE4)]及性激素[血清雌二醇(E_(2))、孕酮(P)及黄体生成素/卵泡刺激素(LH/FSH)]。结果:B组的治疗总有效率显著高于A组,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异均无统计学意义(P>0.05)。术后6、12及24个月B组的复发率均显著低于A组,差异均有统计学意义(P<0.05)。术前,两组的肿瘤标志物及性激素比较,差异均无统计学意义(P>0.05);术后3、6个月,B组的肿瘤标志物及E_(2)、LH/FSH均显著低于A组,P则均显著高于A组,差异均有统计学意义(P<0.05)。结论:甲羟孕酮在早期子宫内膜癌患者宫腔镜电切术后的应用效果显著优于地屈孕酮,且可显著改善患者的肿瘤标志物及性激素,因此甲羟孕酮在早期子宫内膜癌患者中的应用价值相对较高。

宫瘤消胶囊对子宫肌瘤患者性激素、血清HE4、CA125水平及瘤体、子宫体积的影响

目的:探究分析宫瘤消胶囊对子宫肌瘤患者性激素、血清HE4、CA125水平及瘤体、子宫体积的影响,探讨其对子宫肌瘤患者的治疗效果。方法:选取2023年1月至2024年3月本院收治的76例子宫肌瘤患者为研究对象,根据随机数字表法分为两组,各38例,其中对照组遵医嘱单一服用米非司酮治疗,治疗组遵医嘱服用宫瘤消胶囊联合米非司酮治疗,测评比较两组用药治疗前后的性激素、血清肿瘤标志物(HE4、CA125)水平及瘤体、子宫体积情况。结果:经过2个疗程用药治疗后,治疗组的孕激素、雌激素、HE4、CA125指标水平均低于对照组,治疗组的瘤体及子宫体积均小于对照组,差异有统计学意义(P<0.05)。结论:宫瘤消胶囊治疗子宫肌瘤能够有效降低性激素、HE4、CA125水平,有效控制子宫肌瘤的发生与发展,临床应用效果较佳。

巢蛋白和α-抑制素蛋白在不同卵巢性索-间质肿瘤中的表达

目的:探讨巢蛋白(Nestin)和α-抑制素(α-inhibin)蛋白在不同卵巢性索-间质肿瘤(SCST)中的表达情况。方法:选取卵泡膜细胞瘤、卵巢纤维瘤、成年型粒层细胞瘤、卵巢微囊性间质瘤和卵巢低分化支持-莱迪(Sertoli-Leydig)细胞瘤组织标本,制备石蜡切片,行苏木精-伊红染色和α-inhibin、Nestin免疫组织化学染色。采用Spearman法分析Nestin和α-inhibin表达评分的相关性。结果:Nestin在SCST中的卵泡膜细胞瘤、卵巢纤维瘤、成年型粒层细胞瘤中呈阴性表达,在卵巢微囊性间质瘤和卵巢低分化Sertoli-Leydig细胞瘤组织中Leydig细胞呈阳性表达。α-inhibin在卵泡膜细胞瘤、卵巢纤维瘤和成年型粒层细胞瘤呈阳性表达,在卵巢微囊性间质瘤和卵巢低分化Sertoli-Leydig细胞瘤组织中呈阴性表达。Nestin与α-inhibin表达评分无相关性(均P<0.05)。结论:卵泡膜细胞瘤、卵巢纤维瘤、成人型颗粒细胞瘤组织中Nestin蛋白阴性表达,α-inhibin蛋白阳性表达。卵巢微囊性间质瘤、卵巢低分化Sertoli-Leydig细胞瘤组织中Nestin蛋白阳性表达,α-inhibin蛋白阴性表达,且Nestin与α-inhibin蛋白表达无明显关系。

类似卵巢性索肿瘤的子宫肿瘤1例并文献复习

目的探讨类似卵巢性索肿瘤的子宫肿瘤(UTROSCT)的临床及组织病理学特征、诊断与鉴别诊断。方法分析1例UTROSCT的临床资料,行组织形态学、免疫组化检查并复习相关文献。结果UTROSCT细胞排列呈小梁状、巢状,浸润周围平滑肌组织,部分瘤细胞呈上皮样,胞浆嗜酸,部分瘤细胞胞浆透亮或泡沫状,核圆形、卵圆形及短梭形,染色质细腻,可见核沟,部分核仁显著,未见核分裂象、脉管内瘤栓及坏死。免疫组化显示细胞角蛋白(CK)、钙结合蛋白(CR)、CD99、inhibin-A、类固醇生成因子-1(SF-1)、肾母细胞瘤基因-1(WT-1)、雌激素受体(ER)、孕激素受体(PR)阳性;T细胞1识别黑色素瘤抗原(Melan-A)、S100、结蛋白灶状阳性;癌胚抗原(CEA)、上皮膜抗原(EMA)、多肿瘤抑制因子1(MTS/P16)、黑色素瘤相关抗原(HMB45)、平滑肌肌动蛋白(SMA)、CD10、CD34阴性;Ki67增殖指数约1%阳性。结论UTROSCT是一类罕见的具有卵巢性索间质肿瘤特征的子宫肿瘤,临床症状及影像学检查缺乏特异性,依赖术后病理组织形态学及免疫组化确诊,其生物学行为具有低度恶性潜能,大多数呈良性过程,需要长期随访。