通过 CT 鉴别胃肠道来源的原发性和转移性卵巢肿瘤。

Olivia Li, Aya Hamadeh, Ali Pourvaziri, Sarah Mercaldo, Jeffrey Clark, Katherine McLay, Mukesh Harisinghani
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引用次数: 0

摘要

目的:确定原发性卵巢癌与胃肠道源性卵巢转移瘤的 CT 成像特征:回顾性研究:50 例 CT 检查发现卵巢新病变的患者,其中一半为原发性卵巢癌,一半为胃肠道转移瘤。两名独立的盲人阅片员描述 CT 上的肿瘤特征(大小、侧位、边缘等)和辅助特征(腹水、腹膜播散、淋巴结病等)。收集了患者的年龄、性别、癌症病史以及 CA-125 和 CEA 的肿瘤标志物水平。统计分析采用 Wilcoxon 检验和皮尔逊卡方检验:结果:共纳入 50 名患者,平均年龄为 62.1 岁。卵巢转移灶更倾向于囊性/主要为囊性(P=0.013)、边缘光滑(P=0.011)、无/轻度强化(P结论:卵巢转移灶更倾向于囊性/主要为囊性(P=0.013)、边缘光滑(P=0.011)、无/轻度强化(P=0.011):卵巢转移瘤多为边缘光滑、囊性且几乎无强化。原发性卵巢病变多伴有淋巴结病和较大的腹水。肿瘤标志物CEA和CA-125分别在转移灶和原发灶中更常升高。癌症史是增加转移几率的唯一变量,因此必须始终与癌症史相关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differentiating primary from metastatic ovarian tumors of gastrointestinal origin by CT.

Purpose: To determine differentiating CT imaging features of primary ovarian cancers from ovarian metastases of gastrointestinal origin.

Methods: Retrospective study of 50 patients with new ovarian lesions on CT, half were primary ovarian cancers and half gastrointestinal metastases. Two blinded independent readers described tumor characteristics on CT (size, laterality, margin, etc.) and ancillary features (ascites, peritoneal seeding, lymphadenopathy, etc.). Patient age, sex, cancer history, and tumor marker levels for CA-125 and CEA were collected. Wilcoxon test and Pearson's chi-squared test were used for statistical analysis.

Results: 50 patients with mean age of 62.1 years were included. Ovarian metastases were more likely to be cystic/mainly cystic (p=0.013), have smooth margins (p=0.011), and have no/mild enhancement (p<0.001). Primary ovarian lesions were associated with moderate to large volume of ascites (p=0.047) and more commonly seen with lymphadenopathy (p=0.008). Laterality was not significantly different between the two groups. CA-125 level was more commonly elevated in primary ovarian lesions (87% vs 50%, p=0.018), and with much higher values (1076.5 vs 155.1, p=0.013). CEA level was more commonly elevated in metastatic ovarian lesions (83.3% vs 15.4%, p<0.001), and with higher values (72.4 vs 2.1, p<0.001).

Conclusion: Ovarian metastases were more frequently smooth-margined and cystic with little enhancement. Primary ovarian lesions were more commonly associated with lymphadenopathy and larger volume of ascites. Tumor markers CEA and CA-125 were more frequently elevated in metastatic and primary lesions, respectively. Cancer history was the only variable that increased the odds of metastasis and therefore it is important to always correlate with history of cancer.

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