目的:探讨卵巢甲状腺囊肿的诊断及治疗。方法:汇报1例陕西省人民医院妇科诊治的卵巢甲状腺肿病例,分析其临床资料、影像学检查及治疗。并进行文献复习及总结。结果:卵巢甲状腺肿是一种罕见的卵巢良性畸胎瘤,发病率低,且多为良性肿瘤,极...目的:探讨卵巢甲状腺囊肿的诊断及治疗。方法:汇报1例陕西省人民医院妇科诊治的卵巢甲状腺肿病例,分析其临床资料、影像学检查及治疗。并进行文献复习及总结。结果:卵巢甲状腺肿是一种罕见的卵巢良性畸胎瘤,发病率低,且多为良性肿瘤,极少数可进展成为恶性甲状腺肿,以甲状腺乳头状癌和滤泡癌最为常见,目前主要通过单个病例报道文献了解该疾病,目前治疗方案首选手术治疗,若术后发生恶性甲状腺肿转移,给予辅助甲状腺切除及I131治疗并且经验性给予化学治疗。本例卵巢甲状腺肿病例行腹腔镜双侧附件切除术,术后随访8个月,未见复发或远处转移。结论:卵巢甲状腺肿发病率低,首选手术治疗,治疗方案取决于年龄、生育情况、术中情况、肿瘤性质、全身情况,术后若发生恶性甲状腺肿转移,给予辅助治疗。Objective: To explore the diagnosis and treatment of ovarian thyroid cyst. Methods: A case of ovarian goiter diagnosed and treated by gynecology department of Shaanxi Provincial People’s Hospital was reported. The clinical data, imaging examination and treatment were analyzed. And make the literature review and summary. Results: Struma ovarii is a rare benign teratoma of ovary with a low incidence and mostly benign tumors, and very few of them can progress to malignant struma, the most common of which are papillary carcinoma and follicular carcinoma of thyroid. At present, this disease is mainly understood through single case reports and literatures. At present, surgical treatment is the preferred treatment. If malignant goiter metastasis occurs after surgery, adjuvant thyroidectomy and I131 therapy are given and chemotherapy is empirically administered. This case of struma ovarii underwent laparoscopic bilateral adnexectomy and was followed up for 8 months. No recurrence or distant metastasis was observed. Conclusion: The incidence of ovarian goiter is low, the first choice of surgical treatment, treatment depends on age, fertility, intraoperative conditions, tumor nature and systemic conditions. If malignant goiter metastasis occurs after surgery, adjuvant treatment should be given.展开更多
文摘目的检测子痫前期孕妇血清中人端粒酶反转录酶(human telomerase reverse transcriptase,hTERT)、沉默信息调节因子6(silent information regulator 6,Sirt6)表达,并探究hTERT,Sirt6水平表达与疾病严重程度及妊娠结局评估中的价值。方法选取2018年1月~2022年12月在陕西省人民医院进行诊治的300例子痫前期孕妇作为子痫前期组,孕妇均符合《妊娠期高血压疾病诊治指南(2015)》中子痫前期诊断标准,选取同时期孕检的300例健康孕妇为对照组,根据病情严重程度将子痫前期组分为轻症子痫前期组(n=180)和重症子痫前期组(n=120),根据是否发生不良妊娠结局将子痫前期组分为正常妊娠组(n=165)和不良妊娠组(n=135)。酶联免疫吸附实验(enzyme-linked immunosorbnent assay,ELISA)法检测血清中hTERT和Sirt6水平,Spearman相关性分析血清中hTERT和Sirt6水平与子痫前期孕妇病情严重程度的相关性,利用受试者工作特征(receiver operating characteristic,ROC)曲线评估血清hTERT和Sirt6水平在子痫前期诊断及妊娠结局预测中的价值。结果与对照组比较,子痫前期组血清hTERT(22.15±5.82 ng/ml vs 30.12±9.56 ng/ml),Sirt6(5.26±1.62 ng/ml vs 7.06±2.29 ng/ml)水平降低,差异具有统计学意义(t=12.334,11.114,均P<0.001)。与轻症子痫前期组比较,重症子痫前期组孕妇血清hTERT(18.28±4.11 ng/ml vs 24.73±6.96 ng/ml),Sirt6(4.03±1.17 ng/ml vs 6.08±1.92 ng/ml)水平降低,差异具有统计学意义(t=9.142,10.469,均P<0.001)。与正常妊娠组比较,不良妊娠组子痫前期孕妇血清中hTERT(17.75±4.61 ng/ml vs 25.75±6.81 ng/ml),Sirt6(4.06±0.96 ng/ml vs 6.24±2.16 ng/ml)水平降低,差异具有统计学意义(t=11.639,10.878,均P<0.001)。Spearman相关性分析显示,血清hTERT,Sirt6水平与子痫前期孕妇疾病严重程度均呈负相关(r=-0.562,-0.604,均P<0.001)。ROC曲线分析结果显示,血清hTERT,Sirt6诊断子痫前期的曲线下面积(95%置信区间)[AUC(95%CI)]分别为0.711(0.673~0.747),0.727(0.689~0.762),两者联合诊断子痫前期的AUC(95%CI)为0.788(0.753~0.820),高于两者单独诊断(Z=2.719,2.154,P=0.007,0.031);血清hTERT,Sirt6预测子痫前期不良妊娠结局的AUC(95%CI)分别为0.786(0.735~0.831),0.783(0.732~0.829),两者联合预测子痫前期不良妊娠结局的AUC(95%CI)为0.849(0.804~0.888),高于两者单独预测(Z=1.855,1.861,P=0.032,0.031)。结论hTERT和Sirt6在子痫前期孕妇血清中水平较低,与子痫前期孕妇疾病严重程度均呈负相关,并对妊娠结局具有一定的评估价值。
文摘目的:探讨卵巢甲状腺囊肿的诊断及治疗。方法:汇报1例陕西省人民医院妇科诊治的卵巢甲状腺肿病例,分析其临床资料、影像学检查及治疗。并进行文献复习及总结。结果:卵巢甲状腺肿是一种罕见的卵巢良性畸胎瘤,发病率低,且多为良性肿瘤,极少数可进展成为恶性甲状腺肿,以甲状腺乳头状癌和滤泡癌最为常见,目前主要通过单个病例报道文献了解该疾病,目前治疗方案首选手术治疗,若术后发生恶性甲状腺肿转移,给予辅助甲状腺切除及I131治疗并且经验性给予化学治疗。本例卵巢甲状腺肿病例行腹腔镜双侧附件切除术,术后随访8个月,未见复发或远处转移。结论:卵巢甲状腺肿发病率低,首选手术治疗,治疗方案取决于年龄、生育情况、术中情况、肿瘤性质、全身情况,术后若发生恶性甲状腺肿转移,给予辅助治疗。Objective: To explore the diagnosis and treatment of ovarian thyroid cyst. Methods: A case of ovarian goiter diagnosed and treated by gynecology department of Shaanxi Provincial People’s Hospital was reported. The clinical data, imaging examination and treatment were analyzed. And make the literature review and summary. Results: Struma ovarii is a rare benign teratoma of ovary with a low incidence and mostly benign tumors, and very few of them can progress to malignant struma, the most common of which are papillary carcinoma and follicular carcinoma of thyroid. At present, this disease is mainly understood through single case reports and literatures. At present, surgical treatment is the preferred treatment. If malignant goiter metastasis occurs after surgery, adjuvant thyroidectomy and I131 therapy are given and chemotherapy is empirically administered. This case of struma ovarii underwent laparoscopic bilateral adnexectomy and was followed up for 8 months. No recurrence or distant metastasis was observed. Conclusion: The incidence of ovarian goiter is low, the first choice of surgical treatment, treatment depends on age, fertility, intraoperative conditions, tumor nature and systemic conditions. If malignant goiter metastasis occurs after surgery, adjuvant treatment should be given.
