| Purpose:The detailed clinicopathological data of 126 patients with ovarian granulosa cell tumor were analyzed to study the clinicopathological characteristics and high-risk factors of recurr ence.Methods:Retrospectively analyzed the anthropological data of 126 patients with ovarian granulosa cell tumors treated at the Second Affiliated Hospital of Jilin University from December 2015 to August 2021,and used SPSS 21.0 software to perform ttest,logistic regression analysis,consistency test,and Pearson co rrelation test.Results:1.The age ranged from 13 to 83 years,with an average ag e of 48.6 years,a median age of 50 years,and the oldest 40 years.The diameter of the tumor ranges from 1.5cm to the I ower limit of the xiphoid process.The diameter of most tumor s ranges from 5-10cm,accounting for 54.8%.The largest tum or can reach the lower xiphoid process.The common clinical manifestations include irregular vaginal bleeding,abdominal pai n,abdominal distension,etc.among them,the proportion of irr egular vaginal bleeding symptoms reaches 100%.There are 61 cases of abdominal pain（dull pain,acute abdominal pain att ack）,accounting for 48.4%,and 40 cases with abdominal dist ention symptoms,accounting for 31.7%.It was often accompa nied by endometrial thickening（29 cases,23%）,hysteromyom a,adenomyosis and other related diseases（72 cases,57.1%）.Endometrial lesions included simple hyperplasia of endometriu m（16 cases,12.7%）,complex atypical hyperplasia of endomet rium with/without local canceration（5 cases,4.0%）,endomet rial cancer（6 cases,4.8%）,and endometrial polyps（24 cases,19.0%）.2.Preoperative ultrasound showed heterogeneous hypoechoic,with dense medium echo particles and septum in 114 cases（90.5%）,and blood flow signals in some septum or solid parts in 25 cases（19.8%）.The kappa values of preoperative ultras ound,CT and MRI for accurate preoperative diagnosis of ogct were:-0.056 and-0.133 respectively,which were not consist ent in P<0.05.3.CA125 increased occasionally,accounting for 23.8%in 30 cases.The range of CA125 was 2.1～600.Ong/ml,including 20 cases above 100ng/ml,accounting for 15.9%.T-test analy sis of tumor markers and recurrence showed no statistical sig nificance.（P=0.862）4.Independent sample t-test was conducted for initial age an d recurrence,P=0.032,logistic regression analysis,regressio n coefficient-0.062,or=0.940.The earlier the age of onset,the greater the likelihood of recurrence.5.The t-test analysis of tumor classification（juvenile type an d adult type）and recurrence showed that the p value was 0.004,and the prognosis of juvenile type was poor.6.The t-test analysis of postoperative adjuvant chemotherapy and recurrence was 0.065,which was not significant in P<0.05,but statistically significant in P<0.1.Pearson correlation a nalysis was carried out on whether chemotherapy and recurre nce,and the correlation coefficient was 0.211,indicating that t here was a weak correlation between chemotherapy and recur rence,and postoperative adjuvant chemotherapy affected the p rognosis of patients.7.The effects of surgical methods and surgical scope on the prognosis of 126 patients were analyzed.The surgical metho ds were laparotomy（81 cases,64.3%,3 cases of recurrence）and laparoscopic surgery（45 cases,35.7%,2 cases of recur rence）.Pearson correlation analysis was performed on the cho ice of operation mode（laparotomy or laparoscopy）and operati on scope.In the case of P<0.05,the correlation coefficients were 0.018,0.055,-0.041,-0.005,-0.018,-0.066,0.145,-0.060,-0.026,-0.032 respectively.The results showed that the ch oice of laparotomy and laparoscopy had no significant effect o n the prognosis.The scope of surgery had no significant effec t on the prognosis.However,there are few recurrent cases in this study,and the effects of laparotomy,laparoscopy and op eration scope on prognosis need to be further discussed.8.The corresponding P values of immunohistochemical facto rs A-inhibin and CD99 on recurrence were 0.41 and 0.569.Im munohistochemical factors A-inhibin and CD99 did not affect th e prognosis of ogct patients.Due to the small number of recu rrent cases,the results cannot be obtained when the immunoh istochemical factor vimentin is statistically analyzed.Conclusion:1.The clinical manifestations of ogct are common,mainly in cluding vaginal bleeding,abdominal distension and abdominal pain.At the time of onset,the disease stage was early,and s urgical treatment was selected.Often associated with gynecolo gical estrogen related diseases.2.Ogct gynecological ultrasound,CT and MRI have typical characteristics,which are irreplaceable and complementary to each other to improve the accuracy of preoperative diagnosis.3.Tumor markers CA125,immunohistochemical factors（A-in hibin,vimentin,CD99）,the choice of laparotomy and laparosco pic surgery and the scope of surgery have no effect on the pr ognosis,but there are few recurrent cases.This conclusion ne eds to be further verified.4.The age of initial onset,tumor classification and postoper ative adjuvant chemotherapy were related to the prognosis of patients.The younger the age is,the worse the prognosis is.The prognosis of juvenile type is poor.Postoperative adjuvant chemotherapy improves the prognosis. |
