原发性输卵管高级别浆液性癌的临床表现和超声特征OA

Objective To explore the clinical manifestations and ultrasound features of primary high-grade serous carcinoma of the fallopian tube(PHGSC-FT)under the new pathological criteria.Methods A retrospective study was conducted on 45 PHGSC-FT patients diagnosed by postoperative pathology at Obstetrics&Gynecology Hospital of Fudan University from April to June 2023.Clinical data,ultrasound characteristics,and prognosis were analyzed.Results The age of patients was(56.2±10.1)years,with postmenopausal women accounting for 68.9%.The main clinical symptoms were abdominal pain and(or)distension(53.3%),pelvic mass(31.1%),and abnormal vaginal discharge(11.1%).Preoperative ultrasound revealed that 40 cases presented mainly as solid pelvic or abdominal masses(82.5%,33/40),while 5 cases involved widely disseminated small lesions not describable by ultrasound;28 lesions had irregular shapes 70.0%.Intraoperative findings showed that the major lesions were located in the ovary in 27 cases(60.0%),fallopian tube in 7 cases(15.6%),extra-adnexal pelvic in 6 cases(13.3%),and widespread disseminated lesions in 5 cases(11.1%).The accuracy rate of ultrasound localization was 82.2%,and the accuracy rate for benign and malignant differential diagnosis was 75.6%.Serum carbohydrate antigen 125(CA125)levels were significantly lower in patients whose primary lesion was located in the fallopian tube than in those with lesions outside the fallopian tube(P=0.001).FIGO stage Ⅰ:4 cases(8.9%),stage Ⅱ:10 cases(22.2%),stage Ⅲ:23 cases(51.1%),and stage Ⅳ:8 cases(17.8%),with 3-year survival rates of 75.0%,80.0%,56.5%,and 50.0%,respectively.Conclusions PHGSC-FT predominantly occurs in postmenopausal women,and its biological behavior is characterized by"small primary lesion-large metastatic lesion".Prognosis of these patients is related to FIGO stage;Ultrasound demonstrates high accuracy in localization of large lesions and in determining benign versus malignant nature.