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卵巢颗粒细胞瘤预后影响因素的分析 |
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ents with stage Ⅲ～Ⅳ were dead of recurrent disease in 1 year. The frequency of observed mitosis influenced the survival rate: with less 5/10 high-power fields （HPF） the survival were 96% both at 5 and 10 years, with more or equal 5/10 HPF the 5 and 10 year survival rates were 58% and 36%, respectively(P<0.01). No significant correlation could be established between the adjuvant therapy and 5 and 10 years survival in 56 stage Ⅰ patients. There were 44 patients with recurrent disease in this group, median time to recurrence was 53 months. Late recurrence appeared in 8 cases. The significant differences in stage and abdominal mass were noted between the recurrent tumors and the group without disease (P<0.05). When early and late recurring tumors were compared, statistically significant differences were again noted: early recurring tumors had higher mitotic rates and late stage, and late recurring tumors had lower mitotic rages and early stage. Patients without recurrent tumors were similar to the patients with early recurring tumors. Conclusions Tumor stage and mitotic rate are the clinical and pathologic prognosticators in granulosa cell tumor. It is difficult to predict late recurrences using these clinical and pathologic parameters.
【Key words】 Ovarian neoplasms； Granular cell tumor; Prognosis
卵巢颗粒细胞瘤是一组低度恶性肿瘤，约占卵巢肿瘤的2%～3%。尽管大部分患者就诊时肿瘤较局限，多为早期，但仍有部分患者出现复发，其复发特征是远期复发。本研究通过回顾性分析我院过去37年中收治的100例卵巢颗粒细胞瘤患者的临床资料，旨在探讨其预后的影响因素，以指导临床治疗。
资料与方法
一、 资料来源
（一） 研究对象
选择1958～1995年我院收治的105例卵巢颗粒细胞瘤患者，其所有病理切片均经我院病理科同一医生复查核实，其中5例更改诊断为其他卵巢恶性肿瘤，余100例符合卵巢颗粒细胞瘤诊断标准。所有患者按国际妇产科联合会（FIGO）分期标准进行临床分期， 其中Ⅰ期56例，Ⅱ期12例，Ⅲ期3例，Ⅳ期1例，另28例为外院治疗后复发或未控患者。有核分裂相检查记录的共47例。
本组患者的发病年龄为15～71岁，中位年龄为43岁，年龄分布以41～60岁为最多，占62%。绝经前56例，绝经后44例。临床表现主要有：（1）不规则阴道流血38例（38%），其中绝经后流血20例（20%）；（2）闭经不育4例（4%）；（3）腹部包块30例（30%）；（4）腹痛20例（20%）；（5）合并子宫内膜增生23例（23%），子宫内膜腺癌1例（1%），子宫肌瘤14例（14%）。本组共有44例复发。中位复发时间为53个月（4.4年），其中8例为远期复发（≥10年复发），最长复发时间为25年。36例为近期复发（<上一页 [1] [2] [3] 下一页
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