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目的 :分析成人型卵巢粒层细胞肿瘤的疗效 ,并探讨其预后因素。方法 :通过对 5 3例成人型卵巢粒层细胞肿瘤的病史资料和病理切片进行回顾性分析 ,将患者按年龄、分期、肿瘤大小、核分裂数分成四组及复发组(n =15 )和非复发组 (n =38)进行比较 ,用Kaplan Meier生存曲线和Logrank检验。结果 :5 3例中 32例生存 ,1例带瘤生存 ,14例死于复发 ,6例死于其它疾病。各期间生存率有显著性差异 ,Ⅰ期 10年生存率为 80 % ,Ⅱ—Ⅳ期则为41%。肿瘤直径≥ 15cm组生存率明显下降。核发裂≤ 5 / 10HPF者 10年生存率为 10 0 % ,而 >5 / 10HPF组仅 33 % ,二组之间有显著性差异。 15例复发者与 38例无复发者病理特征方面发现Call Exner小体在无复发组中明显多见于复发组患者 ,而明显核异型及高核分裂则多见于复发组病人 ,经过统计学回归分析 ,发现分期、肿瘤大小、核异型及高核分裂仍保持显著性。当早期复发组 (<10年 )和晚期组 (>10年 )进行比较时发现早期复发者Call Exner小体少 ,细胞分裂多 ,核异形明显 ,而晚期复发组与无复发组非常相像。结论 :肿瘤分期是成人型卵巢粒层细胞肿瘤最有意义的临床预后因素 ,其次为肿瘤大小。明显核异形和核分裂数是重要的病理预后因素 ,Call Exner小体也是与预后相关的病理特征。依靠这些
Objective: To analyze the curative effect of adult ovarian granulosa neoplasm and explore its prognostic factors. Methods: The clinical data and pathological sections of 53 adult ovarian granulosa neoplasms were retrospectively analyzed. The patients were divided into four groups according to age, staging, tumor size and mitosis, and the recurrence group (n = 15) Recurrence group (n = 38) was compared with Kaplan Meier survival curves and Logrank test. Results: Of the 53 cases, 32 survived, 1 died of recurrence, and 14 died of other diseases. The survival rates were significantly different during each period, the 10-year survival rate was 80% in stage I and 41% in stage II-IV. Tumor diameter ≥ 15cm group significantly decreased survival rate. The 10-year survival rate of patients with nuclear fissure ≤ 5/10 HPF was 100%, while that of> 5/10 HPF was only 33%. There was a significant difference between the two groups. 15 cases of relapse and 38 cases of no recurrence pathological features of Call Exner body found no recurrence group was significantly more common in patients with recurrent group, and obvious nuclear atypia and high-frequency nuclear division more common in patients with recurrent group, after statistical regression analysis, Staging, tumor size, nuclear atypia, and high-level nuclear division were found to remain significant. When the early recurrence group (<10 years) and the late stage group (> 10 years) compared with the early recurrence Call Exner body found less cell division, nuclear abnormalities were obvious, while the late recurrence group and no recurrence group are very similar. Conclusion: Tumor stage is the most significant clinical prognostic factor for adult ovarian stratum cell tumor, followed by tumor size. Obvious nuclear abnormalities and mitotic counts are important pathological prognostic factors, and Call Exner bodies are also pathological features associated with prognosis. Rely on these