卵巢黄体囊肿破裂15例诊治分析

卵巢黄体囊肿破裂是妇科急腹症之一，常有腹痛、不同程度内出血，临床易误诊为异位妊娠。本文就我院1996年1月至2005年12月经手术及病理确诊的15例卵巢黄体囊肿破裂的急腹症进行诊治，取得了满意的疗效，现报告如下。     

卵泡膜细胞瘤的CT诊断价值

目的分析卵巢卵泡膜细胞瘤的CT特点,提高其CT诊断水平。方法回顾性分析经手术病理证实的5例卵泡膜细胞瘤的CT征象,分析其特点。结果肿瘤形态呈类圆形、卵圆形3例,分叶状2例。肿瘤最大径范围在4.0cm～18.0cm之间。CT平扫密度均匀,CT值23～46Hu,增强扫描肿瘤轻度强化。结论卵泡膜细胞瘤具有良性肿瘤的形态特征,增强扫描后仅轻度强化,CT能很好地显示卵巢卵泡膜细胞瘤的各种特征,对卵巢卵泡膜细胞瘤的诊断和鉴别诊断有重要价值。     

FAS蛋白表达与卵巢癌细胞凋亡的相关性研究

目的 探讨ＦＡＳ基因与卵巢癌细胞凋亡的关系。方法 应用免疫组化技术检测ＦＡＳ蛋白，应用原位末端标记法（ＴＵＮＥＬ）检测卵巢癌细胞凋亡。结果 卵巢癌组织ＦＡＳ蛋白和率为４５．４５％，细胞凋亡阳性率为７５．００％。表达ＦＡＳ蛋白的细胞与凋亡细胞分布区域基本一致。结论 ＦＡＳ基因通过调控细胞凋亡而参与卵巢癌的发生与发展。     

富糖原型卵巢癌

为研究富糖卵巢癌的组织学类型及预后，分析了３０例富糖原型卵巢癌的临床和病理组织学资料，结果表明，富糖原型卵巢癌的患病年龄较为年轻，患者常发生盆腔外转移和子宫内膜异位症。比较各期患者，Ｉ期富糖原型卵巢癌的生存率比普通型显著下降，而其它则无明显差异。提示富糖原型卵巢癌的复发率较高。血管侵袭是预后的差的信号之一     

Differential Expression of Progesterone Receptor Isoforms A and B in the Normal Ovary, and in Benign, Borderline, and Malignant Ovarian Tumors

Human epithelial ovarian neoplasm is well-known to be sex steroid-related, but the possible biological significance of progesterone actions in these tumors remains controversial. In this study, we examined the differential expression patterns of the two progesterone receptor (PR) isoforms, PRA and PRB, using immunohistochemistry and real-tune quantitative RT-PCR in normal and neoplastic ovarian tissues, and in cell lines derived from a normal ovarian surface epithelium and an ovarian epithelial carcinoma in order to further elucidate the possible involvement of progesterone in the development of ovarian neoplasms. The median H scores for PR isoforms in normal ( n =8), benign ( n =10), borderline ( n =8) and malignant ( n =24) ovarian tissues were as follows; PRA: 194.0, 171.0, 49.5, 0 ( P <0.05), and PRB: 175.0, 180.5, 251.5, 168.5, respectively. In ovarian cancer cell lines (OVCAR–3 and Caov–3), the PRB/PRAB mRNA ratio was increased by 17β-estradiol, both tune-and dose-dependently. However, this ratio was unaltered following the addition of 17β-estradiol in a normal ovarian epithelial cell line (NOV–31). Immunoblotting analysis demonstrated that PRB protein expression was markedly up-regulated in OVCAR–3, whereas the PRA and PRB isoforms both appeared to be increased in NOV–31. These results suggest that down-regulation of PRA is associated with the development of ovarian epithelial carcinoma.     

血清CA125测定对卵巢癌的诊断和治疗的意义

从１９８５年５月～１９８９年５月，作者采用单克隆抗体ＯＣ１２５，以放射免疫固相测定法进行检测人血清ＣＡ１２５抗原。测定结果，确定在本文研究中的血清ＣＡ１２５正常值为６５Ｕ／ｍｌ，≤６５Ｕ／ｍｌ为阴性，＞６５Ｕ／ｍｌ为阳性。卵巢上皮性癌患者的血清ＣＡ１２５水平８１．５％（７５／９２）为阳性，明显高于对照人群的２．５％，其中浆液性癌阳性率高达９３．２％（４１／４４）．根据ＣＡ１２５数值的动态变化来观察对评定疗效、预示复发及指导选择二探术等方面的临床意义，ＣＡ１２５阳性的病例不需要接受二探术，ＣＡ１２５水平与肿瘤变化的符合率达９２．９％。这充分证明ＣＡ１２５＞６５Ｕ／ｍｌ水平，肿瘤病灶＞２ｃｍ者，对化疗的反应差，预后也差。     

卵巢及子宫颈恶性淋巴瘤10例临床分析

对１０例卵巢及子宫颈恶性淋巴瘤的临床与病理特点、治疗方法及预后等进行了回顾性分析。结果表明：卵巢和宫颈的原发性淋巴瘤极少见，但其预后比继发性淋巴瘤好；按ＦＩＧＯ标准进行分期，期别的早晚与预后的好坏基本相符；伴有突然发作的腹胀、腹痛和全身症状者的预后差；双侧卵巢肿瘤以及有骨髓侵犯者的预后差；无裂细胞及混合型比小细胞型、大细胞型、免疫细胞型预后差；单纯化疗或放疗较手术后辅助化疗的疗效差；在较彻底的肿瘤细胞减灭术基础上进行化疗，可取得较好的化疗效果；血清乳酸脱氢酶（ＳＬＤＨ）测定可以作为诊断与估价生殖系统淋巴瘤预后的参考指标。     

卵巢无性细胞瘤的治疗：附37例临床分析

３７例卵巢纯性无性细胞瘤，其中２４例为首次治疗，１３例为复发后治疗，３０例作手术切除，１２例加放射治疗，全部３７例均作抗癌化疗１～８疗程。五年生存率６７．５８％，其中Ｉ期１００％（１４／１４），Ⅱ期６０％（３／５），Ⅲ，Ⅳ期均为零（０／４，０／１），复发病例为６１．５３％（８／１３）。１例保留健侧卵巢和子宫已结婚正常产１胎。本文对保留内分泌生育功能及化疗。放疗疗效等进行了分析讨论。     

卵巢原发与转移性粘液腺癌的鉴别──HID－AB、GOS、ConA粘液染色法

卵巢原发与转移性粘液腺癌的鉴别，目前尚无较客观的标准。为寻找出较客观的鉴别标准，以分析其各自粘液性状为目的。本文采用粘液组织化学方法、分别对卵巢原发粘液性腺癌与大肠原发腺癌进行了对照观察。结果发现卵巢原发粘液性腺癌的粘液所见为：１．粘液量丰富，Ｓｉａｌｏ粘液优势。２．具有胃腺窝上皮型和幽门腺型特定型粘液。以上结果发现ＨＩＤ－ＡＢ，ＧｏＳ，ＣｏｎＡ粘液染色法可以作为比较客观的，准确的鉴别手段应用于临床病理诊断中。     

Observations on the ultrasound diagnosis of ovarian neoplasms

Summary In order to determine whether sonography could differentiate between benign and malignant ovarian neoplasms a retrospective analysis of preoperative ultrasound examination was made. The ultrasound images were evaluated for internal consistency, presence of septae, presence of solid nodules, papillary projections and tumor borders. Evidence of ascites and omental involvement were also assessed. Our study showed that benign ovarian serous tumors had a similar appearance to low grade malignant serous tumors, and were undistinguishable from the borderline serous carcinoma. The poorly differentiated serous adenocarcinoma was characterized by the presence of thick papillary projections rather than echogenicity. However, benign or malignant mucinous tumors gave the same pattern. Loss of tumor wall definition, ascites and omental involvement may signal malignancy. The dermoid tumor had a characteristic sonographic appearance.