Malmström H, Högberg T, Risberg B, Simonsen E
Department of Gynecologic Oncology, University Hospital, Linköping, Sweden.
Gynecol Oncol. 1994 Jan;52(1):50-5. doi: 10.1006/gyno.1994.1010.
Granulosa and theca cell tumors of the ovary account for 2-3% of ovarian malignancies. This study includes 54 patients with the diagnosis of granulosa cell tumors of the ovary treated between 1953 and 1987. Median age at diagnosis was 57 (27-83) years. The lesions were staged according to FIGO. The number of patients in various stages was IA, 41; IB, 3; IC, 3; IIB, 6; and III, 1. Median tumor size, 11 cm; range, 0.5-30 cm. Post-menopausal bleeding was diagnosed in 48%, MHC in 37%, proliferative endometrium in 32%, and atypia of endometrial cells in 13% of the cases. Fifty patients were treated with primary surgery, 48 patients were treated with adjuvant external radiotherapy, and 3 patients received complementary chemotherapy. The survival rates in stage I were 94 and 88% after 5 and 10 years, respectively, and in stages II-III were 44% after 5 and 10 years. Overall survival was 90% at 5 years. The frequency of observed mitosis influenced the survival rate: with less or equal 4/10 HPF the survival was 100% in 5 years, with 5-9/10 HPF the survival was 80% in 5 years with a median survival time of 9 years, and with more or equal 10/10 HPF the longest survival was 4 years. At the end of the study, 45 patients (83%) are alive with no evidence of disease, 1 patient is alive with disease, 4 patients are dead of recurrent disease, and 4 patients are dead from intercurrent disease. Endometrial carcinoma was detected in 5 patients. The total survival is better than that with epithelial ovarian cancer as the hormonal symptoms make an early diagnosis possible. Stage for stage the survival is equal. There is an increased incidence of endometrial carcinoma and concomitant other malignancies. The mitotic rate is a well-defined parameter and influences the survival significantly and should be considered the most important prognostic factor at treatment planning.
卵巢颗粒细胞瘤和卵泡膜细胞瘤占卵巢恶性肿瘤的2% - 3%。本研究纳入了1953年至1987年间确诊为卵巢颗粒细胞瘤的54例患者。诊断时的中位年龄为57（27 - 83）岁。病变根据国际妇产科联盟（FIGO）进行分期。各期患者数量分别为：IA期41例；IB期3例；IC期3例；IIB期6例；III期1例。肿瘤中位大小为11 cm；范围为0.5 - 30 cm。48%的病例诊断为绝经后出血，37%为子宫内膜增生，32%为增殖期子宫内膜，13%为子宫内膜细胞异型性。50例患者接受了初次手术治疗，48例患者接受了辅助外照射放疗，3例患者接受了辅助化疗。I期患者5年和10年生存率分别为94%和88%，II - III期患者5年和10年生存率均为44%。5年总生存率为90%。观察到的有丝分裂频率影响生存率：每10个高倍视野（HPF）中小于或等于4个时，5年生存率为100%；每10个HPF中有5 - 9个时，5年生存率为80%，中位生存时间为9年；每10个HPF中大于或等于10个时，最长生存时间为4年。研究结束时，45例患者（83%）存活且无疾病证据，1例患者带瘤存活，4例患者死于复发性疾病，4例患者死于并发疾病。5例患者检测到子宫内膜癌。总体生存率优于上皮性卵巢癌，因为激素症状使得早期诊断成为可能。各期生存率相当。子宫内膜癌及其他伴随恶性肿瘤的发病率增加。有丝分裂率是一个明确的参数，对生存率有显著影响，在治疗规划时应被视为最重要的预后因素。
