Matsuoka Ayumu, Tate Shinichi, Nishikimi Kyoko, Ishikawa Hiroshi, Shozu Makio
Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Menopause. 2016 May;23(5):544-9. doi: 10.1097/GME.0000000000000587.
The aim of the study was to evaluate the association between tumor histology and serum sex hormone levels in postmenopausal women with ovarian tumors.
We preoperatively measured serum levels of gonadotropins and sex steroids, including estradiol, progesterone, and testosterone, in 69 postmenopausal women who underwent surgical resection for ovarian tumors. Tumors were classified as surface epithelial-stromal tumors, sex cord-stromal tumors, germ cell tumors, and metastatic tumors. Surface epithelial-stromal tumors were divided into mucinous, serous, clear cell, and endometrioid tumor subgroups. Patients were divided into two groups depending on tumor type: mucinous and nonmucinous, and any association between these tumor types and serum sex hormone levels were evaluated.
Univariate analyses revealed that serum sex steroid levels were significantly higher in women with mucinous ovarian tumors compared with women with other tumor types. Serum gonadotropin levels, age, body mass index, tumor size, and tumor malignancy status did not affect the sex steroid levels. Multivariate analysis evaluating sex steroid levels and tumor histology revealed that high serum progesterone levels were significantly and independently associated with mucinous ovarian tumors. A serum progesterone cut-off level of at least 1.3 nmol/L was the most accurate for differentiating mucinous tumors from other tumor types (area under the curve, 0.81; sensitivity, 75%; and specificity, 86%).
Serum progesterone levels were significantly elevated in postmenopausal women with mucinous ovarian tumors. In these women, serum progesterone levels may thus represent a useful biomarker for predicting tumor histology preoperatively, which would aid treatment planning.
本研究旨在评估绝经后卵巢肿瘤女性的肿瘤组织学与血清性激素水平之间的关联。
我们对69例接受卵巢肿瘤手术切除的绝经后女性术前测定了促性腺激素和性类固醇的血清水平，包括雌二醇、孕酮和睾酮。肿瘤分为表面上皮-间质肿瘤、性索-间质肿瘤、生殖细胞肿瘤和转移性肿瘤。表面上皮-间质肿瘤又分为黏液性、浆液性、透明细胞和子宫内膜样肿瘤亚组。根据肿瘤类型将患者分为两组：黏液性和非黏液性，并评估这些肿瘤类型与血清性激素水平之间的任何关联。
单因素分析显示，黏液性卵巢肿瘤女性的血清性类固醇水平显著高于其他肿瘤类型的女性。血清促性腺激素水平、年龄、体重指数、肿瘤大小和肿瘤恶性状态均不影响性类固醇水平。评估性类固醇水平和肿瘤组织学的多因素分析显示，高血清孕酮水平与黏液性卵巢肿瘤显著且独立相关。血清孕酮截断水平至少为1.3 nmol/L时，区分黏液性肿瘤与其他肿瘤类型最为准确（曲线下面积为0.81；敏感性为75%；特异性为86%）。
绝经后黏液性卵巢肿瘤女性的血清孕酮水平显著升高。因此，在这些女性中，血清孕酮水平可能是术前预测肿瘤组织学的有用生物标志物，有助于治疗方案的制定。
