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.     

Infected endometrioma in pregnancy masquerading as acute appendicitis

Background A pregnancy complicated by ovarian endometrioma is rare. Other complications of ovarian endometrioma in pregnancy, i.e., rupture and infection are also rare.Case A 35-year-old woman, gravida 2, para 0-0-1-0, at 35 weeks pregnancy, came to the hospital with a right abdominal pain. She also had a history of diarrhea. She had history of infertility and preexisting right endometrioma. The investigations revealed leukocytosis with neutrophils predominant. The preoperative diagnosis was acute appendicitis. Infected right ovarian endometrioma was demonstrated during exploratory laparotomy, opened and drainage of the right endometrioma and appendectomy were performed. The final diagnosis was infected ovarian endometrioma in pregnancy, later confirmed by a pathological report.Conclusion Although complication of ovarian endometrioma such as infected endometrioma during pregnancy is rare, it should be included in the differential diagnosis of pelvic pain during pregnancy, especially in the patient who has history of ovarian endometrioma.     

Massive ovarian oedema: report of two cases

Introduction Massive ovarian oedema is a rare entity characterized by accumulation of oedema fluid in ovarian stroma. Clinically it mimics solid ovarian neoplasm and thus requiring histopathological examination to rule out malignancy. Case report Two cases of massive ovarian oedema are presented and the pathogenesis and management is being discussed.     

Fresh autologous transplantation of ovarian cortical strips to the anterior abdominal wall at the pfannenstiel incision site

OBJECTIVE: To describe an open surgical technique for transplanting fresh ovarion tissue to the anterior abdominal wall at the incision site and to determine whether ovarian function would be restored after transplantation. DESIGN: Case study. SETTING: Academic medical center. PATIENT(S): A 44-year-old patient who underwent an operation for uterine fibroids. INTERVENTION(S): Microsurgical reconstruction of ovarian cortex and its transplantation to the anterior abdominal wall at incision site of Pfannenstiel. MAIN OUTCOME MEASURE(S): Follicular development evident by ultrasound examination; restoration of serum FSH and LH levels to nonmenopausal range; and disappearance of menopausal symptoms. RESULT(S): Early postoperative FSH, LH, and E(2) levels showed that menopause was confirmed. Postoperative hormone levels at months 2, 3, and 6 were as follows: FSH: 77.86, 79.50, and 13.70 mIU/mL; LH: 34.60, 33.92, and 8.78 mIU/mL; E(2): 29, 46, and 48 pg/mL. The patient is still followed-up for postmenopausal status. CONCLUSION(S): Autotransplantation of cortical strips to the anterior abdominal wall at the incision site without further incision can be a logical solution for the patients at early climacteric age.     

Molecular pharmacology of the ovine melatonin receptor: comparison with recombinant human MT1 and MT2 receptors

The variations of the pharmacological properties of melatonin receptors between different mammalian species in transfected cell lines have been poorly investigated. In the present study, melatonin analogues have been used to characterize the pharmacology of the recombinant ovine melatonin receptor (oMT1) expressed in CHO cell lines and the native oMT1 from the pars tuberalis (PT). Studies with selective ligands on native and transfected oMT1 showed similar properties for binding affinities [r2(PT/CHO) = 0.85]. The affinities and the functional activities of these ligands were compared with the human receptors (hMT1 or hMT2) expressed in CHO cells as well. The oMT1 and hMT1 receptors had similar pharmacological profiles (r2=0.82). Nevertheless, some of the selective compounds at the human receptor presented a reduced affinity at the ovine receptor. Furthermore, some compounds showed marked different functional activities at oMT1 vs. hMT1 receptors. Our findings demonstrated differences in the pharmacological properties of melatonin receptors in ovine and human species.     

卵巢囊性畸胎瘤的CT及B型超声诊断

目的比较CT和B超检查对卵巢囊性畸胎瘤诊断的准确率。资料与方法回顾性分析经手术病理证实的30例卵巢囊性畸胎瘤的CT和B超影像资料。结果30例均显示肿瘤内脂肪存在,24例囊内出现Rokitansky结节,25例显示有钙化、牙齿或骨骼。CT和B超对本病的确诊率分别为100%和63%。结论卵巢囊性畸胎瘤的CT诊断准确率优于B超。     

两性腺原发性淋巴瘤26例临床病理分析

目的：探讨发生在睾丸、卵巢的原发性淋巴瘤的临床病理形态特点、临床分期和预后的关系。方法：对21例原发性睾丸恶性淋巴瘤、5例卵巢原发性恶性淋巴瘤进行组织形态学和免疫组织化学染色观察，依据WHO新分类进行分型．AnnArber（1971）国际分期法进行临床分期并结合文献对其临床病理特点及随访资料进行分析。结果：睾丸恶性淋巴瘤平均好发于60．70岁，随访21例患者中，弥漫大B细胞性淋巴瘤13例，中住生存期35．2个月，5年生存率38．5％；T细胞性淋巴瘤5例，中位生存期18．6个月，2年生存率40．0％，无5年生存率。B小淋巴细胞性淋巴瘤1例及淋巴浆细胞样淋巴瘤2例．5年生存率100％。就诊时病程处于Ⅰ期8例，中位生存期75．1个月。Ⅱ期8例．中位生存期36．5个月。Ⅲ、Ⅳ期5例，中位生存期8个月。卵巢原发性恶性淋巴瘤少见，病情进展迅速预后差。本组5例均为B细胞性淋巴瘤，其中小淋巴细胞性3例，淋巴浆细胞样淋巴瘤2例，Ⅰ期1例，Ⅱ期2例，Ⅲ期2例，其中2例失访，随诊3例均于1年内死亡。结论：睾丸原发性恶性淋巴瘤预后与临床分期、组织学分型关系密切，术后放、化疗有利于提高患者生存率，卵巢原发性恶性淋巴瘤预后差。     

TIMP-1基因体外稳定转染对人卵巢癌A2780细胞周期与增殖的影响

目的:探讨正、反义基质金属蛋白酶组织抑制因子-1(TIMP-1)基因对人卵巢癌细胞周期及增殖的影响。方法:将重组质粒正、反义TIMP-1表达载体体外转染到卵巢癌A2780细胞中,用G418筛选稳定表达细胞株并扩增培养,采用MTT细胞计数法检测肿瘤细胞生长增殖率,流式细胞术检测肿瘤细胞周期的变化。结果:经15～20 dG418筛选得到稳定表达细胞株,重组质粒TIMP-1稳定转染正义(PTs)组A2780细胞的增殖可明显受到抑制,细胞周期明显改变,细胞从G1期到S期发生阻滞。而反义(PTas)组细胞与之相反。结论:提示体外转染TIMP-1基因可使A2780细胞周期阻滞于G1期,并可抑制肿瘤细胞增殖。可为临床基因治疗及相关基因药物研究提供实验依据。