Witt B R, Wolf G C, Wainwright C J, Thorneycroft I H
Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, LA.
Gynecol Obstet Invest. 1992;33(1):59-64. doi: 10.1159/000294849.
Two patients with granulosa cell tumors of the ovary, endometrial hyperplasia, elevated serum estradiol (E2) concentrations and depressed FSH levels were studied preoperatively using intravenous administration of FSH, LH and gonadotropin-releasing hormone. In patient 1, serum E2 increased from a baseline of 72.7 to 116.8 pg/ml 60 min after hCG stimulation, with a peak level of 571.4 pg/ml 96 h after hCG administration; there was a rapid postoperative decline to 16 pg/ml. Ovarian venous E2 on the tumor side was 6,979 pg/ml. In patient 2, E2 increased from a baseline of 91 to 449 pg/ml at 20 h after FSH administration. Intraoperative ovarian venous E2 was 9,788 pg/ml. Inhibin, which was elevated in patient 1 prior to stimulation (736 fmol/ml), peaked 96 h after hCG administration. Ovarian venous inhibin concentration in patient 1 was 2,911 fmol/ml. The baseline inhibin concentration in patient 2 was not elevated (249 fmol/ml), but there was an elevation of inhibin in response to FSH administration (757 fmol/ml), but no response to hCG. Ovarian inhibin concentration was not different between the tumor and contralateral sides in patient 2. Both granulosa cell tumors were responsive to exogenous gonadotropin stimulation. Although only one tumor made significant baseline levels of inhibin, the production of inhibin by both tumors was apparently stimulated by FSH.
对两名患有卵巢颗粒细胞瘤、子宫内膜增生、血清雌二醇（E2）浓度升高和促卵泡生成素（FSH）水平降低的患者，术前采用静脉注射FSH、促黄体生成素（LH）和促性腺激素释放激素进行研究。在患者1中，人绒毛膜促性腺激素（hCG）刺激60分钟后，血清E2从基线水平72.7 pg/ml升至116.8 pg/ml，hCG给药96小时后达到峰值水平571.4 pg/ml；术后迅速降至16 pg/ml。肿瘤侧卵巢静脉E2为6979 pg/ml。在患者2中，FSH给药20小时后，E2从基线水平91 pg/ml升至449 pg/ml。术中卵巢静脉E2为9788 pg/ml。患者1在刺激前抑制素水平升高（736 fmol/ml），hCG给药96小时后达到峰值。患者1卵巢静脉抑制素浓度为2911 fmol/ml。患者2的抑制素基线浓度未升高（249 fmol/ml），但对FSH给药有抑制素升高反应（757 fmol/ml），但对hCG无反应。患者2肿瘤侧和对侧卵巢抑制素浓度无差异。两个颗粒细胞瘤对外源性促性腺激素刺激均有反应。虽然只有一个肿瘤产生显著的基线水平抑制素，但两个肿瘤的抑制素产生显然都受到FSH刺激。
