Enhancing the accuracy of preoperative and intraoperative evaluation of malignant ovarian germ cell tumors with a focus on fertility preservation in young women

IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
U Chul Ju, Woo Dae Kang, Seok Mo Kim
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Abstract

ObjectiveTo analyze and improve the accuracy of preoperative assessment and intraoperative frozen‐section analysis (FSA) for malignant ovarian germ cell tumors (MOGCTs), especially in the context of fertility preservation.MethodsA retrospective review of 48 women aged under 40 years, diagnosed with MOGCTs, and treated at Chonnam National University Hospital between July and December 2022 was conducted. The results of preoperative magnetic resonance imaging (MRI), measurement of serum tumor markers (α‐fetoprotein [AFP], β‐human chorionic gonadotropin, lactate dehydrogenase [LDH], cancer antigen [CA] 125, CA 19–9, CA 72–4, carcinoembryonic antigen), and intraoperative FSA were compared with the final pathology diagnosis.ResultsMRI demonstrated a sensitivity of 95.5%, whereas FSA showed a sensitivity of 72.9% for all MOGCTs. Sensitivities varied according to the subtype, but were consistently higher in MRI (100% for dysgerminoma, 88.9% for immature teratoma, 100% for endodermal sinus tumor, 100% for others). However, there were differences in FSA according to subtype (100% for dysgerminoma, 50.0% for immature teratoma, 100% for endodermal sinus tumor, 25.0% for others). Serum tumor markers also provided diagnostic insights, particularly LDH for dysgerminoma (82.4%) and AFP for immature teratoma (75.0%) and endodermal sinus tumor (100%).ConclusionPreoperative MRI and serum tumor marker measurement may be effective in guiding fertility‐sparing surgical decisions. MRI could outperform FSA in terms of accuracy, especially for immature teratoma.
提高恶性卵巢生殖细胞瘤术前和术中评估的准确性,重点关注年轻女性的生育能力保护
方法 对2022年7月至12月期间在全南国立大学医院接受治疗的48名年龄在40岁以下、确诊为恶性卵巢生殖细胞瘤的女性进行回顾性研究。将术前磁共振成像(MRI)结果、血清肿瘤标志物(α-胎儿蛋白[AFP]、β-人绒毛膜促性腺激素、乳酸脱氢酶[LDH]、癌抗原[CA]125、CA 19-9、CA 72-4、癌胚抗原)测量结果和术中FSA结果与最终病理诊断结果进行比较。结果 MRI 对所有 MOGCT 的灵敏度为 95.5%,而 FSA 的灵敏度为 72.9%。敏感性因亚型而异,但 MRI 的敏感性始终较高(畸形胚胎瘤 100%、未成熟畸胎瘤 88.9%、内胚窦瘤 100%、其他 100%)。然而,不同亚型的 FSA 存在差异(畸形胚胎瘤为 100%,未成熟畸胎瘤为 50.0%,内胚层窦瘤为 100%,其他为 25.0%)。血清肿瘤标记物也提供了诊断依据,尤其是畸形精原细胞瘤(82.4%)的 LDH 和未成熟畸胎瘤(75.0%)及内胚窦瘤(100%)的 AFP。就准确性而言,磁共振成像优于 FSA,尤其是在未成熟畸胎瘤方面。
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来源期刊
CiteScore
5.80
自引率
2.60%
发文量
493
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.
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