235例卵巢畸胎瘤临床病理分析

目的:探讨卵巢畸胎瘤的临床病理特点.方法: 对235例卵巢畸胎瘤患者的临床病理资料进行分析.结果: 235例卵巢畸胎瘤病例中各个年龄均有发生,以20-40岁多发.其中卵巢成熟性囊性畸胎瘤228例,占97%;卵巢未成熟性畸胎瘤4例,占1.7%;卵巢成熟性囊性畸胎瘤恶变2例,占0.9%;卵巢畸胎瘤伴甲状腺类癌1例,占0.4%.结论:卵巢畸胎瘤绝大多数为良性,应及时手术,以减少并发症的发生,未成熟畸胎瘤及恶变者较少,应结合临床综合治疗.     

235例卵巢畸胎瘤临床病理分析

目的：探讨卵巢畸胎瘤的临床病理特点。方法：对235例卵巢畸胎瘤患者的临床病理资料进行分析。结果：235例卵巢畸胎瘤病例中各个年龄均有发生,以20—40岁多发。其中卵巢成熟性囊性畸胎瘤228例,占97％;卵巢未成熟性畸胎瘤4例,占1．7％;卵巢成熟性囊性畸胎瘤恶变2例,占0．9％;卵巢畸胎瘤伴甲状腺类癌1例,占0．4％。结论：卵巢畸胎瘤绝大多数为良性,应及时手术,以减少并发症的发生,未成熟畸胎瘤及恶变者较少,应结合临床综合治疗。     

卵巢囊性成熟性畸胎瘤恶变11例分析

为了了解卵巢囊性成熟性畸胎瘤恶变临床特征及预后 ,对 11例卵巢囊性成熟性畸胎瘤恶变的临床症状、肿瘤分期、病理类型、治疗进行回顾性分析。结果 11例患者平均生存时间为 6 8 6个月 (12～ 16 8个月 ) ,5年生存率为5 7 2 %。研究结果提示 ,卵巢囊性成熟性畸胎瘤恶变发生率低、恶性度高 ,手术治疗 ,辅以化、放疗有一定疗效。     

卵巢囊性成熟性畸胎瘤恶变11例分析

为了了解卵巢囊性成熟性畸胎瘤恶变临床特征及预后,对11例卵巢囊性成熟性畸胎瘤恶变的临床症状、肿瘤分期、病理类型、治疗进行回顾性分析。结果11例患者平均生存时间为68．6个月（12－168个月）,5年生存率为57．2％。研究结果提示,卵巢囊性成熟性畸胎瘤恶变发生率低、恶性度高,手术治疗,辅以化、放疗有一定疗效。     

卵巢成熟性囊性畸胎瘤恶变临床及预后分析

卵巢成熟性囊性畸胎瘤恶变临床并不多见 ,一般认为其发生率低于卵巢成熟性囊性畸胎瘤恶变及卵巢未成熟性畸胎瘤 ,多发生于老年妇女。现对我科1986年— 1999年间收治的 13例卵巢成熟性囊性畸胎瘤恶变病例的临床及预后因素分析如下。1　资料与方法1.1　一般资料　 13例卵巢成熟性囊性畸胎瘤恶变占本院同期收治卵巢恶性肿瘤的 1.32 % ,卵巢成熟性囊性畸胎瘤发病年龄偏小 ,而恶变时年龄较大。本组13例中 84.6 %发生在 41岁～ 6 9岁 ,中位年龄 48岁 ,已绝经者占 6 1.5 %。1.2　临床表现　 13例卵巢成熟性囊性畸胎瘤恶变中 11例有下腹胀或下腹部肿…     

卵巢成熟囊性畸胎瘤恶变临床病理观察

目的探讨卵巢成熟囊性畸胎瘤(Mature cystic teratoma,MCT)恶变的临床病理特征.方法回顾性分析卵巢MCT恶变10例,对其病理分型、临床特点进行讨论.结果卵巢MCT恶变占良性MCT的1.7%,其中鳞状细胞癌8例,基底细胞癌1例,腺癌1例.临床多表现为下腹部肿物,8例局限于卵巢,2例侵犯宫旁、盆壁及直肠.2例死亡,其余8例均无瘤生存.结论卵巢MCT恶变多发生于绝经后妇女,以鳞癌为最多;当卵巢MCT囊壁较厚时,病理检查需细致,警惕其恶变.治疗以手术为主;肿瘤局限于卵巢者预后较好,已侵犯其它部位者预后差.     

卵巢成熟性畸胎瘤恶变为腺癌1例

卵巢成熟性畸胎瘤恶变为腺癌十分罕见,确诊主要依赖病理检查及免疫组化,治疗以手术治疗为主,辅以化疗或放疗,临床Ⅰ期预后相对较好.本文回顾性分析1例卵巢成熟性畸胎瘤恶变为腺癌病例的临床特点及诊治方法,并结合相关文献进行总结报道,以提高对这类疾病的认识.     

卵巢原发甲状腺肿类癌的临床病理分析

目的:探讨卵巢原发甲状腺肿类癌的临床病理特征.方法:观察和分析2例卵巢原发甲状腺肿类癌病例的病理组织学及免疫表型的特点,并复习相关文献进行讨论.结果:例1卵巢类癌伴有成熟性囊性畸胎瘤成分,例2为单纯甲状腺肿类癌,类癌成分呈岛状与小梁状生长,甲状腺滤泡成分与类癌相互混杂.类癌的细胞比较一致,胞浆嗜酸性,染色质均匀,核分裂象少见.免疫组化2例类癌成分CK(+),CK19(+),CD56(+),NSE(+),Syn(+),TTF-1和TG散在阳性,甲状腺成分TTF-1(+)、TG(+).卵巢甲状腺肿类癌应与甲状腺癌鉴别,甲状腺癌的肿瘤细胞有高分裂活性,没有神经内分泌分化,细胞岛状或梁状分布不明显.结论:卵巢甲状腺肿类癌是罕见的低度恶性肿瘤,预后较好,病理形态学观察和免疫组化染色有助于明确诊断.     

卵巢成熟性畸胎瘤376例临床病理分析

卵巢成熟性畸胎瘤又称皮样囊肿 ,是卵巢常见的肿瘤之一 ,仅次于卵巢囊腺瘤 ,居第 2位。为探讨其临床及病理特点 ,我们对收治的 3 76例卵巢成熟性畸胎瘤进行了临床病理分析 ,现报告如下。1　临床资料1.1　一般资料我院自 1980年 1月至 2 0 0 0年 12月收治卵巢成熟性畸胎瘤 3 76例 ,均经病理学检查确诊 ,占同期所收治的卵巢肿瘤的3 8.6% (3 76/973 ) ,占生殖细胞肿瘤的 95 .9% (3 76/3 92 )。其中成熟性囊性畸胎瘤 3 71例 (98.7% ) ,成熟性实性畸胎瘤 5例(1.3 % )。患者年龄 10个月～ 71岁 ,平均年龄 3 3 .4岁。以 2 0～ 40岁为多见 ,共 3 2 1…     

卵巢成熟性畸胎瘤恶变为腺癌1例

卵巢成熟性畸胎瘤恶变为腺癌十分罕见,确诊主要依赖病理检查及免疫组化,治疗以手术治疗为主,辅以化疗或放疗,临床Ⅰ期预后相对较好。本文回顾性分析1例卵巢成熟性畸胎瘤恶变为腺癌病例的临床特点及诊治方法,并结合相关文献进行总结报道,以提高对这类疾病的认识。     

Malignant Transformation Rate and P53, and P16 Expression in Teratomatous Skin of Ovarian Mature Cystic Teratoma

Objective: To investigate the incidence of malignant transformation and P53 and P16 expression interatomatous skin of ovarian mature cystic teratoma. Materials and Methods: Data on ovarian teratomaspecimens in nearly 10 years were reviewed. P53 and P16 expression were detected by immunohistochemistryin 25 cases of teratomatous skin of ovarian mature cystic teratoma, 20 cases of squamous cell carcinoma and 2cases of squamous cell carcinoma originated from teratomatous skin. Results: Of 1913 cases of ovarian maturecystic teratoma in nearly 10 years, only two cases of squamous cell carcinoma were found in teratomatous skin,with malignant transformation rate of 0.1045%. P53 expression was detected in 2 cases squamous cell carcinomaoriginated from teratomatous skin and P16 overexpression in one. There were no expressions of P53 and P16 in25 cases of teratomatous skin of ovarian mature cystic teratoma. Of 20 cases of squamous cell carcinoma P53overexpression (positive rate of 55%) was detected in 11 cases, P16 overexpression (positive rate of 35%) in 7cases. The positive rates of P53 and P16 expression in squamous cell carcinomas were significantly higher thanthat in the teratomatous skins (p< 0.001, p= 0.002). Conclusions: There was low risk of malignant transformationin teratomatous skin of ovarian mature cystic teratoma which can be explained by lower P53 and P16 expressioninteratomas than that in squamous cell carcinoma.     

Malignant transformation of mature cystic teratoma of the ovary including three cases occurring during follow-up period

The aim of this study was to seek for factors which lead to the early diagnosis of malignant transformation from mature cystic teratoma. Fourteen patients with malignant transformation from mature cystic teratoma of the ovary were analyzed retrospectively for precise clinicopathology and prognosis. The results demonstrated that although all the patients with stage Ia disease were disease-free, only 2 out of 7 patients were stage Ic to IV and disease-free in the follow-up period. Pre-operative imaging correctly diagnosed tumors as malignant in all stage Ic to IV cases, but only in 2 out of 4 stage Ia cases with magnetic resource and none of the 2 cases with computed tomography, respectively. In malignant cases, elevation of the serum SCC and CEA was observed in 90.9 and 88.9%, respectively. On the other hand, in benign cases, a false positive elevation of the serum SCC and CEA was observed in 23.5 and 14.3%, which turned out to be normal in 40 and 52.9% cases in the repeated study, respectively. In conclusion neither imaging analysis nor tumor markers including SCC and CEA accurately diagnose malignant transformation of mature cystic teratoma in its early stage, suggesting that a combination of diagnostic means is important. In the follow-up cases, repeated measurement of serum markers proved useful in ruling out false positive cases.     

卵巢成熟性畸胎瘤恶变的术中冷冻切片分析

背景与目的：卵巢成熟性畸胎瘤(mature cystic teratoma，MCT)发生恶变非常罕见，术前诊断困难，常需通过术中快速冷冻切片(frozen section，FS)，明确诊断后指导临床医师开展进一步手术，该研究旨在探讨卵巢MCT发生恶变时，导致术中冷冻切片诊断与最终诊断不一致的相关因素，以期提高其诊断的准确性。方法：回顾性分析2008年9月—2017年9月就诊于四川大学华西第二医院的MCT病例，重点分析发生恶变病例的临床病理学特征及导致术中冷冻发生误诊的因素，并复习相关文献。结果：9 213例卵巢MCT患者中有5 790例送检术中冷冻切片，发生恶变的患者共18例。恶变成分为鳞状细胞癌8例、腺癌6例、类癌1例、腺鳞癌1例、恶性纤维组织细胞瘤1例及恶性黑色素瘤1例。18例患者中有14例术中冷冻切片诊断与最终诊断的肿瘤良恶性相符合，4例通过冷冻切片能够确定恶性成分发生于卵巢畸胎瘤。结论：对卵巢畸胎瘤恶变冷冻切片诊断与最终诊断不符合的病例复检切片发现，取材失误是主要原因。尽管术前诊断困难，在基本危险因素（患者年龄和肿瘤体积）之外结合影像学改变并伴有血清肿瘤标志物升高时应该积极开展术中冷冻切片检查以明确诊断。     

小儿卵巢肿块及肿瘤超声检查的声像图特点及其诊断价值

目的：探讨小儿卵巢肿块及肿瘤的超声检查声像图特点及其诊断价值.方法：回顾性分析38例不同年龄段小儿卵巢肿块及肿瘤的临床资料及超声图像表现,并与手术病理结果对照.结果：超声提示腹部肿块4例,卵巢良性肿瘤33例,卵巢恶性肿瘤1例.以上病例均经手术及病理证实,其中,正常卵巢扭转4例,单纯性囊肿14例,伴蒂扭转10例,畸胎瘤19例,伴蒂扭转7例,以囊性为主者13例,以实性为主者6例,实性卵巢内胚窦瘤l例.结论：超声检查结合临床特点有助于小儿卵巢肿块及肿瘤的诊断及其良恶性的鉴别诊断,为手术治疗提供重要依据.     

Clinical evaluation of mature teratomas containing malignant elements

We investigated the possibility of preoperative diagnosis and clinical features of mature ovarian teratoma containing malignant elements (MOTME). Between 1982 and 1998 in our hospital, MOTME accounted for 2.0% (5 cases) of the total of 251 patients with mature ovarian teratoma (ages, 37-72; mean age, 60.6). Serum CA19-9, CA125, SCC and CEA levels were high. All cases were strongly suspected malignancies, preoperatively diagnosed using serum tumor markers with diagnostic imaging. Two cases of stage I squamous cell carcinoma and one case of borderline malignancy survived, while the other two advanced cases died within 8 months.     

胸腺肿瘤诊断和治疗的有关问题 (附73例报告)

目的：探讨良性胸腺瘤复发原因及胸瘤新的分类方法、恶性胸肿瘤的影像学诊断特点、手术方式、合并重症肌无力患者的处理、胸腺肿瘤术后治疗等。方法：１９７５年１月－１９９５年１２月手术治疗的７３例胸腺肿瘤和囊肿。结果：总结了恶性胸腺瘤的ＣＴ特征,恶性胸腺肿瘤应争取全胸腺及用脂肪组织切除,重视合并重症肌无力的围手术期 和潜在恶笥胸腺瘤术后应放疗,复发病例再手术仍能获得较好疗效。结论：提出了一种胸腺瘤新的分类方     

An ovarian mucinous adenocarcinoma arising from mature cystic teratoma associated with respiratory type tissue: a case report

Mature cystic teratoma (dermoid cyst) is the most common benign germ cell tumor of the ovary, accounting for approximately 30% of all ovarian tumors. Malignant transformation is rare; the most frequent transformation reported is to squamous-cell carcinoma in 80% of cases, whereas transformation to adenocarcinoma is described in about 7% of cases. We report a case of malignant transformation to mucinous adenocarcinoma arising from respiratory-like epithelium in a mature teratoma of the ovary.     

卵巢原发性类癌的临床病理观察

目的探讨卵巢类癌的临床病理、免疫组化特点及其与预后的关系。方法对10例卵巢类癌临床及病理资料进行复习,应用SP法免疫组织化学染色并随访。结果患者年龄26-72岁。肿块部位：右侧卵巢7例,左侧卵巢3例。光镜下癌细胞大小、形状、染色较一致,排列呈实性小巢状或岛状、梁状、腺泡状。10例CK、Syn均为（＋）,7例NSE、CgA为（＋）。TG、TTF-1、α-inhibin、ER和PR均（-）。7例获随访者均存活。结论卵巢类癌是少见的卵巢单胚层畸胎瘤,生物学行为低度恶性,需结合组织病理形态、免疫组织化学染色和临床资料对卵巢原发性类癌进行诊断和鉴别诊断。