PDF(Pubmed)
Abstract：
UNASSIGNED: Yolk sac tumors (YSTs) are rare and highly malignant ovarian malignancies that have a very poor prognosis. The aim of this study is to delineate the ultrasound and clinicopathological features of female pelvic YSTs to better understand the disease.
UNASSIGNED: This study was a retrospective analysis of the clinicopathological and ultrasound imaging data from 16 YST patients who received treatment at our hospital between January 2012 and August 2023. Then, the ultrasound imaging characteristics were compared with pathological findings.
UNASSIGNED: Among the 16 patients, various degrees of serum AFP increase were observed, and CA125 levels increased in 58.33% (7 out of 12) of patients. Thirteen patients (81.25%) had tumors located in ovary, two patients (12.5%) had tumors located in the sacrococcygeal region, and one patient (6.25%) had tumors located in the mesentery. Pathologically, nine patients presented with simple yolk sac tumors and seven with mixed germ cell tumors. According to the ultrasound manifestations, YST lesions can be classified into three types. (1) the cystic type, was diagnosed in two patients who presented with a large cystic mass with regular morphology and clear boundary and dense liquid within the cyst; and (2) the cystic-solid mixed type, was diagnosed in 4 patients. On 2D ultrasound, the lesions showed a cystic-solid mixed echo, and color Doppler showed a rich blood flow signal in the solid region and cystic separation. made up of four cases. (3) In ten patients with the solid type, 2D ultrasound showed solid uniform echoes with clear boundaries. The \"fissure sign\" was observed in the lesion. Color Doppler displayed rich blood flow in the solid part, and PW showed low to moderate resistance index of artery (RI:0.21-0.63). On contrast-enhanced ultrasound (CEUS), rapid and high enhancement in the solid part and cystic separation was observed in 2 patients.
UNASSIGNED: Combining ultrasound features with clinical information and tumor markers provides reliable clues for the diagnosis of YST. The application of two-dimensional ultrasound and CEUS combined with patient tumor marker levels can provide a robust reference for determining the necessity of fertility-preserving surgery and postoperative chemotherapy, which can improve clinical decision-making and patient consultation.
UNASSIGNED: This study was a retrospective analysis of the clinicopathological and ultrasound imaging data from 16 YST patients who received treatment at our hospital between January 2012 and August 2023. Then, the ultrasound imaging characteristics were compared with pathological findings.
UNASSIGNED: Among the 16 patients, various degrees of serum AFP increase were observed, and CA125 levels increased in 58.33% (7 out of 12) of patients. Thirteen patients (81.25%) had tumors located in ovary, two patients (12.5%) had tumors located in the sacrococcygeal region, and one patient (6.25%) had tumors located in the mesentery. Pathologically, nine patients presented with simple yolk sac tumors and seven with mixed germ cell tumors. According to the ultrasound manifestations, YST lesions can be classified into three types. (1) the cystic type, was diagnosed in two patients who presented with a large cystic mass with regular morphology and clear boundary and dense liquid within the cyst; and (2) the cystic-solid mixed type, was diagnosed in 4 patients. On 2D ultrasound, the lesions showed a cystic-solid mixed echo, and color Doppler showed a rich blood flow signal in the solid region and cystic separation. made up of four cases. (3) In ten patients with the solid type, 2D ultrasound showed solid uniform echoes with clear boundaries. The \"fissure sign\" was observed in the lesion. Color Doppler displayed rich blood flow in the solid part, and PW showed low to moderate resistance index of artery (RI:0.21-0.63). On contrast-enhanced ultrasound (CEUS), rapid and high enhancement in the solid part and cystic separation was observed in 2 patients.
UNASSIGNED: Combining ultrasound features with clinical information and tumor markers provides reliable clues for the diagnosis of YST. The application of two-dimensional ultrasound and CEUS combined with patient tumor marker levels can provide a robust reference for determining the necessity of fertility-preserving surgery and postoperative chemotherapy, which can improve clinical decision-making and patient consultation.
摘要：
■卵黄囊瘤（YSTs）是罕见且高度恶性的卵巢恶性肿瘤，预后极差。这项研究的目的是描绘女性盆腔YSTs的超声和临床病理特征，以更好地了解该病。
■本研究是对2012年1月至2023年8月在我院接受治疗的16例YST患者的临床病理和超声成像数据的回顾性分析。然后，将超声影像学特征与病理结果进行比较。
■在16名患者中，观察到不同程度的血清AFP升高，58.33%(12人中有7人)的患者CA125水平升高。13例（81.25%）肿瘤位于卵巢，2例(12.5%)肿瘤位于骶尾部,1例(6.25%)肿瘤位于肠系膜。病理上,9例患者为单纯卵黄囊肿瘤，7例混合生殖细胞肿瘤。根据超声表现，YST病变可分为三种类型。（1）囊性，在两名患者中被诊断为具有规则的形态和清晰的边界以及囊肿内的致密液体的大的囊性肿块；和（2）囊实混合型，在4名患者中诊断。在二维超声，病灶表现为囊实性混合回声,彩色多普勒显示实区和囊性分离有丰富的血流信号。由四个案例组成。(3)在10例实型患者中，二维超声显示出坚实均匀的回声，边界清晰。在病变中观察到“裂隙征”。彩色多普勒显示固体部分血流丰富，PW表现为低至中度动脉阻力指数（RI：0.21-0.63）。在超声造影（CEUS）上，在2例患者中观察到固体部分的快速和高度增强和囊性分离。
■将超声特征与临床信息和肿瘤标志物相结合，为YST的诊断提供了可靠的线索。二维超声和CEUS联合患者肿瘤标志物水平的应用可以为确定保留生育功能手术和术后化疗的必要性提供有力的参考。这可以改善临床决策和患者咨询。
■本研究是对2012年1月至2023年8月在我院接受治疗的16例YST患者的临床病理和超声成像数据的回顾性分析。然后，将超声影像学特征与病理结果进行比较。
■在16名患者中，观察到不同程度的血清AFP升高，58.33%(12人中有7人)的患者CA125水平升高。13例（81.25%）肿瘤位于卵巢，2例(12.5%)肿瘤位于骶尾部,1例(6.25%)肿瘤位于肠系膜。病理上,9例患者为单纯卵黄囊肿瘤，7例混合生殖细胞肿瘤。根据超声表现，YST病变可分为三种类型。（1）囊性，在两名患者中被诊断为具有规则的形态和清晰的边界以及囊肿内的致密液体的大的囊性肿块；和（2）囊实混合型，在4名患者中诊断。在二维超声，病灶表现为囊实性混合回声,彩色多普勒显示实区和囊性分离有丰富的血流信号。由四个案例组成。(3)在10例实型患者中，二维超声显示出坚实均匀的回声，边界清晰。在病变中观察到“裂隙征”。彩色多普勒显示固体部分血流丰富，PW表现为低至中度动脉阻力指数（RI：0.21-0.63）。在超声造影（CEUS）上，在2例患者中观察到固体部分的快速和高度增强和囊性分离。
■将超声特征与临床信息和肿瘤标志物相结合，为YST的诊断提供了可靠的线索。二维超声和CEUS联合患者肿瘤标志物水平的应用可以为确定保留生育功能手术和术后化疗的必要性提供有力的参考。这可以改善临床决策和患者咨询。
