背景:颗粒细胞瘤(GCT)被认为是最常见的性索间质肿瘤。这些肿瘤占卵巢肿瘤的3-6%。GCT分为2种类型:青少年GCT(JGCT)和成人GCT(AGCT)。大多数患者在疾病过程中被早期诊断并且倾向于具有良好的预后。在GCT的手术治疗中,两个主要因素在确定手术的可行性中起作用:年龄和肿瘤分期。
方法:对黎巴嫩各地不同医院诊断为卵巢GCT的65名连续女性患者进行了回顾性研究,这些患者被转诊到国家病理学研究所,贝鲁特-黎巴嫩,2000年1月至2020年1月。然后,它们按类型分为:成人型和青少年型。使用Stata进行统计分析,版本16.
结果:黎巴嫩人口中GCT的发病率为每年16.2/百万。研究人群的平均年龄为55.6岁。AGCT是最常见的,患病率为91%,而JGCT为19%。此外,在77.2%的成人病例中发现了抑制素(最重要的免疫标记)。高有丝分裂指数和高肿瘤大小是不良预后的预测因子,分别为20%和36.9%。关于组织病理学特征,与成人型(36.9%)相比,在青少年型(两者均为16.7%)中观察到沟槽核和Exner体的频率较低。大多数GCT患者在病程早期诊断主要是由于症状表现为腹痛,绝经后出血或经期出血,以及黎巴嫩良好的诊断和筛查方法。关于复发病例,与高有丝分裂指数(76.9%)显著相关,发现高肿瘤大小(92.3%)和晚期(3期46%,4期46%),p<0.05。
结论:黎巴嫩人口中GCT的发病率为每年16.2/百万。黎巴嫩的大多数GCT患者为成人型,约占病例的90%。年纪大了,高有丝分裂指数和大肿瘤大小是预后不良的预测因素.
BACKGROUND: Granulosa Cell Tumors (GCT) are considered the most frequent type of sex-cord stromal tumors. These tumors constitute 3-6% of neoplasms of the ovaries. GCTs are divided into 2 types: Juvenile GCT (JGCT) and Adult GCT (AGCT). Most patients are diagnosed early in the course of the disease and tend to have a favorable prognosis. In the surgical treatment of GCT, two main factors play role in the determination of feasibility of the surgery: age and tumor stage.
METHODS: A retrospective
study was conducted on 65 consecutive female patients diagnosed with ovarian GCT at different hospitals across Lebanon who were referred to the National Institute of Pathology, Beirut-Lebanon, between January 2000 and January 2020. Then, they were divided according to types: adult versus juvenile type. Statistical analysis was carried out using Stata, version 16.
RESULTS: The incidence of GCT in a Lebanese population was 16.2 per million per year. The mean age of the studied population was 55.6 years. AGCT was the most common with a prevalence of 91% versus 19% for JGCT. Also, inhibine (the most important immunomarker) was found in 77.2% of adult cases. High mitotic index and high tumor size which are predictors for poor prognosis were respectively 20% and 36.9%. Concerning the histopathological features, Grooved nuclei and Exner bodies were less frequently observed in juvenile type (16.7% for both) compared to adult type (36.9%). Most patients with GCT were diagnosed in the early course of disease mainly due to the manifestation of the symptoms as abdominal pain, postmenopausal bleeding or intermenstrual bleeding, and the good diagnosis and screening practices in Lebanon. Regarding the recurrent cases, a significant correlation with high mitotic index (76.9%), high tumor size (92.3%) and advanced stage (46% for stage 3 and 46% for stage 4) was found with a p < 0.05.
CONCLUSIONS: The incidence of GCT in the Lebanese population is 16.2 per million per year. The majority of patients with GCT in Lebanon are of Adult type representing around 90% of cases. Older age, high mitotic index and big tumor size are predictors for poor outcomes.