摘要
目的探讨幼年型卵巢颗粒细胞瘤(JGCT)的临床病理特征及预后。方法回顾性分析1975—2005年间收治的10例 JGCT 患者(JGCT 组)的临床病理资料,并以同期随机(系统抽样法)选择的成年型卵巢颗粒细胞瘤(AGCT)患者10例作为对照(AGCT 组)。结果 JGCT 组患者的发病年龄为7～31岁,平均20.5岁,其中30岁以前发病者占90%;肿瘤直径为5.5～15.0 cm,平均9.8cm;肿瘤细胞排列为结节状,伴含有黏液的滤泡结构,瘤细胞黄素化明显;细胞核呈中～重度异型性,核分裂象常见[3～5个/10高倍镜视野(HPF)],未见核沟和 Call-Exner 小体。AGCT 组患者的发病年龄为14～74岁,平均45.1岁,70%的患者40岁以后发病;肿瘤直径为5.0～21.0 cm,平均11.7 cm;肿瘤细胞排列为多样性,滤泡规则无黏液,细胞黄素化少见;细胞核呈轻度异型性,核分裂象不多见(0～3个/10 HPF),核沟和 Call-Exner 小体常见。免疫组化检测结果显示,JGCT 组患者增殖细胞核抗原(PCNA)、p53蛋白阳性表达率分别为90%、70%,AGCT 组患者 PCNA、p53蛋白阳性表达率分别为20%、10%,分别比较,差异均有统计学意义(P<0.05);p53、PCNA 蛋白的阳性表达率随着细胞异型性程度的增加而递增,轻度与中～重度异型性细胞的 p53、PCNA 蛋白的阳性表达率(p53蛋白分别为1/8和58%,PCNA 蛋白分别为2/8和75%)分别比较,差异均有统计学意义(P<0.05)。JGCT 组患者的5年生存率为90%,AGCT 组患者为100%,两组比较,差异有统计学意义(P<0.05)。结论JGCT 患者与 AGCT 相比,其发病年龄较轻,肿瘤细胞的异型性明显、核分裂象多见,PCNA、p53蛋白阳性表达率高,预后较差。
Objective To explore elinieopathologieal features and prognosis of juvenile granulosa cell tumor （JGCT）. Methods Patients were divided into JGCT group （ n = 10 ） and the adult granulosa cell tumor （AGCT） group （n = 10 ）. The tumor samples were examined by HE and immunohistochemical methods. Results Age of JGCT group ranged from 7 -31 years （average 20. 5 years） ;90% occurred before 30 years old. Diameter of the tumors ranged from 5.5 cm to 15.0 cm , average 9.8 cm. Characteristic features included nodular arrangement, irregular formation of follicles containing mucin and luteinization, atypical hyperplasia of cells and high mitotic activity. Nuclei grooved and Call-Exner bodies were absent or rare. Survival rate was 90% in 5 years. Age of AGCT group ranged from 14 - 74 years （ average 45.1 years） ; AGCT occurred mostly in over 40 years old. Atypical hyperplasia of cell, mitotic activity and luteinization were absent or rare. Nuclei grooved and call-Exner bodies were common. Survival rate was 100% in 5 years. Immunohistochemical staining were positive for p53 at 70% ,PCNA at 90% in 10 cases of JGCT and p53 at 10%, PCNA at 20% in 10 cases of AGCT（ P 〈0. 05 between two groups）. Conclusions JGCT differs in clinicopathologic feature from the AGCT. It has higher mitotic activity and nuclear atypicality as well as the expression of PCNA and p53. Prognosis of JGCT is worse than AGCT.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2007年第8期533-536,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
卵巢肿瘤
颗粒细胞瘤
免疫组织化学
预后
Ovarian neoplasms
Granular cell tumor
Immunohistochemistry
Prognosis
