Kang Jia, Mei Dongyan, Xing Xiaoyan, Cao Yang, Liang Dandan, Shi Honghui
National Clinical Research Center for Obstetric and Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Obstetrics and Gynecology, Yangzhou Hospital of Traditional Chinese Medicine, Nanjing, China.
Int J Gynaecol Obstet. 2025 Feb;168(2):613-619. doi: 10.1002/ijgo.15908. Epub 2024 Sep 18.
The aim of the study was to investigate the clinical characteristics, therapy strategies and prognosis of Sertoli-Leydig cell tumors (SLCTs).
A total of 50 cases of ovarian SLCTs were retrospectively analyzed. We performed descriptive statistics to describe baseline characteristics.
A total of 70% of SLCT patients were below the age of 45 years. The dominant pathologic types were poor (40%) and moderate (40%) differentiation. Retiform variant tumor is more aggressive and tends to appear in children. According to the 2014 FIGO (the International Federation of Gynecology and Obstetrics) classification, tumors were classified as Stage I (n = 46: well differentiated, n = 4; moderately differentiated, n = 19; poorly differentiated, n = 18; and retiform, n = 5), Stage II (n = 1, moderately differentiated), Stage III (n = 1, poorly differentiated), and Stage IV (n = 2: poorly differentiated, n = 1; and retiform, n = 1). Median follow-up was 58.1 months (2-132 months). A total of 45 patients (90%) achieved clinical remission. Four patients experienced a relapse (34.5 months, range: 7-58) and one patient died of the tumor at 10 months after initial treatment. All patients in grossly Stage IA achieved complete response, irrespective of the presence or absence of staging surgery or chemotherapy. After treatment, five patients successfully gave birth to healthy babies.
The prognosis for women diagnosed with early stage (I-II) SLCT is generally favorable, especially Stage IA. while those with advanced stages, poorly differentiated, retiform variant, or tumors containing heterologous components exhibit a more aggressive clinical course. Fertility sparing surgery appears to represent a feasible treatment approach for early stage SLCTs.
本研究旨在探讨支持-间质细胞瘤（SLCTs）的临床特征、治疗策略及预后。
回顾性分析50例卵巢SLCTs患者的资料。采用描述性统计方法描述基线特征。
70%的SLCT患者年龄小于45岁。主要病理类型为低分化（40%）和中分化（40%）。网状变型肿瘤侵袭性更强，且多见于儿童。根据2014年国际妇产科联盟（FIGO）分类，肿瘤分为Ⅰ期（n = 46：高分化，n = 4；中分化，n = 19；低分化，n = 18；网状，n = 5）、Ⅱ期（n = 1，中分化）、Ⅲ期（n = 1，低分化）和Ⅳ期（n = 2：低分化，n = 1；网状，n = 1）。中位随访时间为58.1个月（2 - 132个月）。45例患者（90%）实现临床缓解。4例患者复发（34.5个月，范围：7 - 58个月），1例患者在初始治疗10个月后死于肿瘤。所有大体分期为ⅠA期的患者均获得完全缓解，无论是否进行分期手术或化疗。治疗后，5例患者成功产下健康婴儿。
诊断为早期（Ⅰ - Ⅱ期）SLCT的女性预后通常良好，尤其是ⅠA期。而晚期、低分化、网状变型或含有异源性成分的肿瘤临床病程更具侵袭性。保留生育功能手术似乎是早期SLCTs的一种可行治疗方法。
