恶性卵巢甲状腺肿发病机制和诊疗的研究进展

恶性卵巢甲状腺肿发病机制和诊疗的研究进展
白杨;周先荣
【期刊名称】《国际妇产科学杂志》
【年(卷),期】2015(042)006
【摘要】Struma ovarii is a highly specific and single endoderm differentiated mature teratoma and is composed predominantly of thyroid tissue. Malignant transformation of benign monodermal teratoma is a rare presentation of struma ovarii, reported that the rate is about 0.5%-5%. It is believed that malignant struma ovarii (MSO) has similar molecular mechanism such as BRAF, RAS mutation and RET/PCT rearrangements with the malignant tumors originating in the thyroid. Because of its clinical rare,currently there is still a lack of clear diagnostic criteria and principles of management. Some cancer experts advocated the use of primary thyroid carcinoma pathological criteria as the diagnostic basis of MSO. Complete surgical staging and adjuvant therapy such as total thyroidectomy, or thyroxine suppression, radioactive iodine ablation and external radiotherapy should be considered when the MSO has been diagnosed. It is observed that patients with MSO have an excellent disease-specific survival rate,postoperative adjuvant therapy can significantly improve the efficacy. Long-term follow-up after surgery were needed, thyroglobulin and total body 131I scan are useful as tumor marker for detection of metastases or tumor recurrence.%卵巢甲状腺肿是具有高度
特异性的单胚层分化的成熟畸胎瘤,其主要由甲状腺组织构成. 良性卵巢甲状腺肿的恶变率低,为0.5%~5%. 恶性卵巢甲状腺肿(MSO)与起源于甲状腺的恶性肿瘤具有相似的分子发病机制,如BRAF (B-Raf proto-oncogene)、RAS (retrovirus-associated DNA sequence) 基因点突变,RET/PTC (RET proto-
oncogen/papillary thyroid carcinoma)基因重排等. 因MSO临床罕见,目前仍缺乏明确的诊断标准及处理原则. 一些肿瘤专家主张用原发性甲状腺癌的病理标准作为MSO的诊断依据. MSO一旦确诊后,应行全面的手术分期和术后的辅助治疗,辅助治疗包括全甲状腺切除或甲状腺素抑制治疗、放射性碘治疗、体外照射等. 临床观察发现MSO预后均较好,且术后辅助治疗起重要作用. 术后需要长期随访,血清甲状腺球蛋白、131I全身扫描是检测肿瘤转移和复发的特异性指标.
【总页数】4页(P608-611)
【作者】白杨;周先荣
【作者单位】200011 上海,复旦大学附属妇产科医院妇产科;200011 上海,复旦大学附属妇产科医院妇产科
【正文语种】中文
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