摘要
目的:探讨卵巢甲状腺肿(SO)的临床、检验、影像、病理、治疗等方面的特征。方法:回顾性分析2013年9月至2021年12月浙江大学医学院附属妇产科医院157例经术后病理检查确诊为SO患者的临床资料。结果:157例患者的中位年龄44岁(12~74岁)。110例患者行妇科体检发现盆腔包块就诊,1例术前检查发现合并甲状腺功能亢进,1例发现血清肿瘤糖类抗原125(CA_(125))显著升高并伴有大量腹水。所有患者均接受手术治疗,并经术后病理确诊,其中良性154例,恶性3例。术前影像学检查对良性SO的检出率分别为:超声0.6%、CT 16.7%、磁共振成像(MRI)26.0%。良性SO中91例(59.1%)行囊肿剔除术,47例(30.5%)行单侧或双侧附件切除术,16例(10.4%)行全子宫+单侧或双侧附件切除术。3例恶性SO术中冰冻病理检查均未提示恶性病变,1例恶性患者术后行化疗。所有患者术后平均随访18.4个月无复发。结论:SO较少见,常无特异性临床表现,辅助检查特异性较低,囊肿剔除或患侧附件切除适用于良性SO。恶性SO发病率低,术中冰冻病理检查不易确诊,尚无统一的治疗方案,手术治疗为主,预后较良好。
Objective:To investigatetheclinical,laboratory,imaging,pathological and therapeutic characteris-tics of struma ovari(SO).Methods:The clinical data of 157 cases of SO diagnosed by postoperative pathology in Women's Hospital,School of Medicine,Zhejiang University from September 2013 to December 2021 were ana-lyzed retrospectively.Results:The median age was 44 years(12-74 years).Of those patients,110 cases un-derwent gynecological examination and found pelvic masses for treatment.One patient had preoperative examina-tion and was found to have hyperthyroidism.1 case was found to have increased serum CA_(125) accompanied by massive ascites.All patients received surgical treatment and were diagnosed by postoperative pathology,among which 154 were benign,3 were malignant.The detection rates of benign SO in preoperative imaging examinations were 0.6%by ultrasound,16.7%by CT and 26.0%by MRl,respectively.In benign SO,91 cases(59.1%)underwent tumorectomy,47 cases(30.5%)underwent single/bilateral salpingo-oophorectomy,and 16 cases(10.4%)underwent hysterectomy plus unilateral/bilateral salpingo-oophorectomy.None of the 3 malignant cases showed any malignant lesions by intraoperative pathology.1 malignant case received postoperative chemo-therapy.All patients were followed up for an average of 18.4 months without recurrence.Conclusion:SO is rela-tively rare,which occurs with no specific clinical manifestations and low specificity of auxiliary examination.Tumor-ectomy or salpingo-oophorectomy is the appropriate therapeutic treatment for benign SO.The incidence of malig-nant so is low,and it is difficult to be diagnosed by intraoperative pathology.There is no standard treatment for malignant sO,surgery is the main treatment,whereas with a good prognosis.
作者
徐文娴
周坚红
XU Wenxian;ZHOU Jianhong(Department of Gynecology,Women's Hospital,School of Medicine,Zhejang University,Hangzhou Zhejiang,310006,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2023年第5期391-394,共4页
Journal of Practical Obstetrics and Gynecology
基金
浙江省科技厅重点研发项目(编号:2019C03026)
浙江大学医学院附属妇产科医院“4+X”临床研究启动项目(编号:ZDFY2022-4XA101)。
