| Background and objectiveTeratoma is a germ cell tumor.It is a heterogeneous tumor differentiated from primordial germ cells to multiple directions.Germ cell tumors account for 30%of the primary ovarian tumors,of which 95%belong to mature cystic teratoma.At present,the clinicopathological study of teratoma at home and abroad is mainly focused on the cases of rare sites of teratoma and the diagnosis and treatment of the common site of the ovary and testis.In recent years,what are the characteristics of the pathological structure,clinical manifestation and age distribution of the teratoma due to the improvement of medical diagnosis and treatment technology and the change of people’s lifestyle?The Pearl River Delta has many foreign population and has strong representativeness.In view of this,we collated and reviewed the clinicopathological data of the teratoma patients in the main hospitals of the Pearl River Delta in 2004-2016,and analyzed the condition of the teratoma,the characteristics of the teratoma,the pathological features of the different pathological types of teratoma,and discussed the clinical and pathological features of the teratoma.The Pearl River Delta region is the main population inflow area of the country,with a floating population of 40 million 480 thousand.The analysis of the data of the teratoma in this area is helpful to understand the clinicopathological distribution of teratoma in Southern China and even the whole country.MethodsChapter Ⅰ Distribution of teratoma population in the Pearl River Delta in the past 2004-2016 years1.A total of 23,683 cases of teratoma diagnosed in the pathology department and 1 pathological diagnosis center of 15 tertiary general hospitals in the Pearl River Delta Region from January 2004 to December 2016 were collected.All patients underwent surgical treatment and all sections were confirmed by two pathologists2.Statistics and analysis of the general characteristics of teratoma patients.3.SPSS 21.0(IBM)software was used for data analysis.Measurement data were analyzed by t-test(mean of two variables)and analysis of variance(more than two variables mean).Qualitative data were analyzed by x 2 test.The results of continuous variables are expressed as mean(X)and standard deviation(SD).Chapter Ⅱ Pathological composition and trend analysis of teratoma in Pearl River Delta in 2004-20161.Analyze the pathological type and location of teratoma data collected in the first part.2.Analyze the pathology,site composition,and trends of teratoma pathogenesisChapter Ⅲ Pathological characteristics of ovarian teratoma1.A total of 1132 cases of ovarian mature teratoma were diagnosed in 1132 cases of ovarian mature teratoma and 107 cases of ovarian immature teratoma were collected from January 2014-2016 year December in the center for pathological diagnosis of silver in Southern Medical University.2.The pathological number,age,location,pathological specimen,observation data and pathological data of all cases of ovarian teratoma were recorded in Excel documents,and the data were analyzed with SPSS 21(IBM)software.The quantitative data were tested by t test,and qualitative data were tested by 2.The results of continuous variables are expressed in terms of mean(X)and standard deviation(SD).Chapter Ⅳ Ovarian thyroid papillary carcinoma with squamous cell carcinoma of the cervix:a case analysis of ovarian mature teratoma1.A case of papillary thyroid carcinoma and cervical squamous cell carcinoma occur in the mature ovarian teratoma of Southern Medical University.2.The characteristics of gross specimens were observed:hematoxylin and red staining and immunohistochemical staining were used to observe the microstructure.ResultsChapter Ⅰ Distribution of teratoma population in the Pearl River Delta in the past 2004-2016 years1.Female teratoma patients accounted for 97.37%of the total patients,of which women of childbearing age(20-40 years)accounted for 79.95%of women patients,which is the main group of patients.2.General condition of patients:The average age of onset of mature teratoma patients and immature teratomas was(32.51±11.18)years and(23.92±12.36)years,respectively,and the onset age of immature teratomas was less than The former(P<0.05).The average age of male teratoma was less than that of female patients(P<0.05).3.The overall number of teratomas in the Pearl River Delta region increased from 2004 to 20164.The number of patients in the 25 to 30 age group continues to increase,and the increase is the largest of all age groups.5.The number of patients in the age groups of 0～,5～,10～,55～,and≥ 60～5 fluctuates little in the past 13 years,and the number of cases per year is less than 3%.Chapter Ⅱ Pathological composition and trend analysis of teratoma in Pearl River Delta in 2004-20161.Mature teratoma accounts for 96.14%of all teratomas and is the most common pathological type.2.The most common site of teratoma is ovary,accounting for 94.82%,followed by mediastinal,testicular,peritoneal,intracranial,pelvic,intraspinal,and other.3.There are gender differences in the location of intracranial teratoma.The common parts of women are saddle region,ventricles,cerebellum,and pineal gland The common parts of men are pineal gland,ventricle and saddleChapter Ⅲ Pathological characteristics of ovarian teratoma1.The age range of ovarian teratoma patients was 6 to 86 years old,and the average age was(32.21 ± 10.65)years.The average age of onset of ovarian mature teratomas was older than that of immature teratomas.2.The tumor diameter of ovarian teratoma patients ranges from 0.5 to 30.0 cm,and the average diameter is(6.01 ±3.73)cm.The diameter of immature ovarian teratoma tumors is larger than that of ovarian mature teratomas.The former is about the latter.double.The size of the ovarian teratoma tumor can be used to distinguish its pathological type.When the teratoma diameter is less than 2.0 cm,it can be diagnosed as ovarian mature teratoma;when the teratoma diameter is greater than 21.0 cm,it can be diagnosed as immature ovarian teratoma.When the diameter of the teratoma is between 2.0 and 21.0 cm,we divide the average diameter of the teratoma into low,medium,and high risk grades,that is,when the diameter of the teratoma is 2.0 to 5.0 cm.For the low-risk tendency,the medium-risk tendency tends to be 5.0 to 12.5cm,and it tends to be high-risk when 12.5 to 21.0cm.The ovarian mature teratoma tumors accounted for 92.75%of the diameter of 0～10 cm,and the ovarian immature teratoma tumor diameter of>10 cm accounted for 71.96%.Chapter Ⅳ Ovarian thyroid papillary carcinoma with squamous cell carcinoma of the cervix:a case analysis of ovarian mature teratoma1.General examination:The cervix saw a gray-yellow mass with a size of about 10cm × 3.5cm × 3.5cm.The cut surface was gray-yellow in quality.The mass occupies the entire os of the cervix,and the visual mass of the infiltrated cervix muscle exceeds 1/2;Lateral ovarian tumors were gray-gray and gray-brown cysts,with a size of 7.5cm×4.5cm×.5cm,and a cyst wall thickness of about 0.2cm to 1.7cm.They contained gray-yellow oil and hair-like substances,and a grayish-yellow head was seen in the wall of the capsule.Festival,attached to the tooth-like material,cut the cyst wall thickness of 1.5cm to see a gray-yellow nodules,diameter of about 1.5cm,nodules cut grayish yellow,slightly tough;the right ovarian tumor was grayish yellowish brown cystic,The size of about 7cm × 3cm × 1.5cm,the wall thickness of about 0.3cm～0.7cm,containing gray yellow oil and hair-like material,see a gray head section of the wall.2.Microscopically:In the cervix,the cancer cells showed irregular nested or papillary growth.The size of the cancer cells was different.The cytoplasm was red stained,the nucleus was deeply stained,the heterotypic appearance was obvious,and the mitoses were more common than the keratinized beads.Formation,some areas see cancer tissue necrosis.Left ovary:The cyst wall tissue is lined with stratified squamous epithelium,and a large number of skin glands,sweat glands,and hair follicle skin appendages are visible;partial thyroid tissue is partially localized,some thyroid tissue is neoplastic,and the tumor cells show multiple papillary structures or Tubular structure,visible papillary fiber axis;tumor cells cubic,red cytoplasm,arranged closely,visible nuclear groove;right ovary:cystic tissue lining the stratified squamous epithelium,showing a large number of sebaceous glands,sweat glands and hair follicle skin Attachment,interstitial hyperplasia of fibrous connective tissue3.Immunohistochemical results confirmed that the cervix tumor was a moderately differentiated squamous cell carcinoma,and the left ovarian mature cystic teratoma was associated with goitre formation and thyroid papillary carcinoma,and the right ovarian mature cystic teratomaConclusion1.The major prevalence of teratomas in the Pearl River Delta region of China is female,the ratio of females to males is 36.95:1;the average age of onset of teratomas is(32.17±11.34)years,and the average incidence of female teratomas is 1.The age of(32.12±11.12)years old,the average age of onset of male teratoma patients was(22.91±15.12)years,and the average age of onset of female patients was 9.21 years older than that of male patients;the average age of female mature teratomas was(32.66±11.16 years old,7.52 years older than the average age of immature teratoma patients(25.14±11.04);the average age of male mature teratoma patients was(24.31±14.93)years older than immature teratogenicity The average age of patients with fetal tumors(20.19± 15.16)was 4.12 years old.2.The pathological type of teratoma is mainly mature teratoma,and the ratio of mature teratoma and immature teratoma is 24.91:1.The main site of female teratoma patients is ovaries,accounting for about 97.38%of female teratomas,and male teratoma mainly occurs in mediastinal(34.62%),testis(28.69%),and intracranial(16.19%).3.Intracranial teratoma mainly occurs in men,with a male to female ratio of 2.97:1.The ratio of intracranial mature teratoma to immature teratoma was 1.60:1.The female teratoma patients mainly occurred in the sellar region(20.59%),ventricle(17.65%)and pineal gland(11.76%).The intracranial lesions of the male teratoma mainly occurred in the pineal gland(50.50%)and the ventricle(17.82%).The average tumor diameter of immature teratoma of the ovary was(12.96±5.93)cm,and the mean tumor diameter of the mature ovarian teratoma was(5.36±2.64)cm,the former being 2.42 times that of the latter.The tumor diameter of ovarian mature teratoma was mainly below 10cm(92.75%),while the tumor diameter of immature teratoma was mainly above 10cm(71.96%).Ovarian mature teratoma and immature teratoma were mainly unilateral,accounting for 91.25%and 98%,respectively.The size of the ovarian teratoma tumor can be used to distinguish its pathological type.When the teratoma diameter is less than 2.0 cm,it can be diagnosed as ovarian mature teratoma;when the teratoma diameter is greater than 21.0 cm,it can be diagnosed as immature ovarian teratoma.When the diameter of the teratoma is between 2.0 and 21,0 cm,we divide the average diameter of the teratoma into low,medium,and high risk grades,that is,when the diameter of the teratoma is 2.0 to 5.0 cm.For the low-risk tendency,the medium-risk tendency tends to be 5.0 to 12.5cm,and it tends to be high-risk when 12.5 to 21.0cm.5.Papillary thyroid carcinoma combined with cervical cancer can occur in mature ovarian teratoma. |
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