摘要
目的探讨卵巢性索间质肿瘤(ovarian sex cord-stromal tumors,OSCSTs)的超声特征及其与临床表现的相关性,并分析误诊原因。方法回顾性分析2012年12月至2020年1月在我院经阴道及/或经腹部超声检出并经手术病理证实为OSCSTs的患者术前临床资料,分析相关临床表现和总结其超声特征。结果50例分别为纤维-卵泡膜瘤组(OTFG)33例、颗粒细胞瘤(GCT)10例、硬化性间质瘤(SST)5例、中分化支持-间质细胞瘤(SLCT)2例,首发症状有月经紊乱(38.0%,19/50)、绝经后阴道流血(6.0%,3/50)、腹痛/腹胀(12.0%,6/50)。OTFG多为实质性回声(81.8%,27/33),常伴后方回声衰减(66.7%,22/33),多为1、2级血流(90.9%,30/33);GCT大多有囊性成分存在(70.0%,7/10),后方回声无衰减,多为3、4级血流(80%,8/10)。OSCSTs的良性病变和非良性病变之间瘤体大小、囊性成分存在、彩色血流信号的差异有统计学意义(P<0.05)。结论OSCSTs是一种有内分泌功能的妇科肿瘤,超声特征结合临床症状可提高这类肿瘤的超声鉴别诊断能力,再进一步结合患者的血清性激素检测可提高术前诊断准确性。
objective To investigate the relevance between the ultrasound characteristics and clinical manifestations of ovarian sex cord-stromal tumors(OSCSTs)and to analyze the reasons for misdiagnosis.Methods By retrospectively analyzing the preoperative clinical data of patients who were diagnosed as OSCSTs through vaginal and/or abdominal ultrasound in our hospital from December 2012 to January 2020 and analyzing relevant clinical manifestations as well as summarizing their ultrasound characteristics.results among all 50 cases,there were 33 cases of ovarian thecoma-fibroma(ovarian thecoma-fibroma groups,OTFG),10 cases of granular cell tumor(GCT),5 case of sclerosing stromal tumor(Sclerosing stromal tumor,SST)and 2 cases of Sertoli-Leydig cell tumor(SLCT)respectively.The first symptoms included menstrual disorders(38.0%,19/50),postmenopausal vaginal bleeding(6.0%,3/50)and abdominal pain/bloating(12.0%,6/50).Most OTFG was of substantive echo(81.8%,27/33)accompanied by posterior echo attenuation(66.7%,22/33)and was level 1 and 2 blood flow(90.9%);most GCT has cystic components(70.0%,7/10)and has no attenuation of the rear echo with grade 3 or 4 blood flow(80.0%,8/10).The difference in in tumor size,cystic composition,and color blood flow signal between the benign and non-benign lesions of OSCSTs was statistically significant(P<0.05).conclusions OSCSTs were gynecological tumors with endocrine function.The combination of ultrasound characteristics with clinical symptoms might help to identifying this tumor and further combination with the detection of serum sex hormones in patients might improve the accuracy of preoperative diagnosis.
作者
刘向娇
尚宁
廖敏彦
陈紫霞
耿娟
盖媛媛
LIU Xiang-jiao;SHANG Ning;LIAO Min-yan;CHEN Zi-xia;GENG Juan;GAI Yuan-yuan(Guangdong maternal and Child Health Hospital,Guangdong Guangzhou 511400,China)
出处
《实用妇科内分泌电子杂志》
2020年第9期3-6,22,共5页
Electronic Journal of Practical Gynecological Endocrinology
基金
广东省重点领域研发计划项目(No.2020B1111130002)
关键词
卵巢
性索间质肿瘤
超声检查
ovary
sex cord stromal tumour
Ultrasonography
