卵巢伴少量性索成分的间质肿瘤临床病理学观察

目的：探讨卵巢伴少量性索成分的间质肿瘤（stromal tumor with minor sex cord elements）的临床病理特征、免疫表型、诊断、鉴别诊断及治疗与预后。方法：对4例卵巢伴少量性索成分的间质肿瘤的临床表现、病理学形态、免疫组织化学（免疫组化）等进行观察，并对检索到的相关文献中报道的9例患者的临床和病理资料进行复习总结。结果：卵巢伴少量性索成分的间质肿瘤好发于中老年女性，患者常以腹部不适和阴道出血等症状就诊，多发生于卵巢，常为单侧。肿瘤最大直径多数大于4 cm，镜下均为典型的纤维瘤或卵泡膜瘤背景中混有少量的性索成分（小于10%），其中性索成分部分为颗粒细胞形态，部分为类似于Sertoli细胞的管状结构。免疫组化染色显示肿瘤中的性索成分α-inhibin、CD99、Calretinin均为阳性。4例患者随访至今，均呈无瘤存活状态，文献报道中的9例患者随访至相关文献发表时亦呈无瘤存活状态。结论：卵巢伴少量性索成分的间质肿瘤的诊断依赖于特征性的组织学表现及免疫组化染色特点，临床表现类似于纤维卵泡膜瘤，部分病例出现雌激素升高症状，罕见病例出现雄激素升高症状，治疗方法为手术切除，预后较好。

Clinicopathological Characteristics of Ovarian Stromal Tumor with Minor Sex Cord Elements

Objective：To explore the clinicopathological characteristics, immunophenotype, diagnosis, differential diagnosis, treatment and prognosis of ovarian stromal tumor with minor sex cord elements. Methods：Four cases of ovarian stromal tumor with minor sex cord elements were studied with histopathological and immunohistochemical staining, and their clinical and pathological findings were analyzed. The clinical and pathological data of 9 cases reported in the related literature were reviewed and summarized. Results：Ovarian stromal tumors with minor sex cord elements are frequently seen in middle-aged and elderly women. Patients often experience abdominal discomfort and vaginal bleeding. The tumors occur mostly in one of the ovaries. The maximum diameter of the tumor was larger than 4 cm. Histologically, the tumor was comprised mainly of fibro-thecoma component with few sex cord elements (less than 10%). Sex cord components varied in appearance between fully differentiated granulosa cells and tubular structures resembling immature Sertoli cells. All of the four cases showed positive staining for α-inhibin，CD99, and Calretinin. Four patients were followed up to the present and all of them showed no tumor survival. Nine cases in the literature were followed up to the publishment of related references, and all exhibited no tumor survival. Conclusions：The diagnosis of ovarian stromal tumor with minor sex cord elements is based on distinctive histopathology and immunohistochemical staining. Its clinical manifestation is similar to other sex cord-stroma tumors. Surgical resection is the main method of treatment, and the prognosis of the tumor is good.