国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (6): 637-641.

• 论著 • 上一篇    下一篇

72例卵巢交界性肿瘤的回顾性分析

张丽，邱丽华   

  1. 200127上海交通大学医学院附属仁济医院妇产科 上海市妇科肿瘤重点实验室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-12-15 发布日期:2015-12-15

Retrospective Analysis of 72 Cases of Borderline Ovarian Tumors

ZHANG Li，QIU Li-hua   

  1. Department of Obstetrics and Gynecology，Key Laboratory of Shanghai Gynecological Tumor, Ren Ji Hospital，School of Medicine，Shanghai Jiao Tong University，Shanghai 200127，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-12-15 Online:2015-12-15

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摘要： 目的：通过对近10年收治的卵巢交界性肿瘤（borderline ovarian tumors，BOTs）病例进行分析，更加全面、深刻地认识BOTs，分析BOTs的预后及影响预后的因素。方法：收集并分析2004年3月—2014年10月上海交通大学医学院附属仁济医院诊治的72例BOTs患者的病史资料。结果：患者诊断年龄为（46.4±17.3）岁，≤40岁的患者占41.7%（30例）；绝经患者占30.6%（22例）；65.3%（47例）的患者无明显临床症状。术前CA125升高（＞35 U/L）者占50.9%（29例），CA199升高（＞37 U/L）者占31.6%（18例）。浆液性（38例）、黏液性（31例）BOTs包块直径中位数分别为80 mm和185 mm；黏液性BOTs包块直径大于浆液性BOTs（P＜0.001）。Ⅰa期患者占72.2%（52例），Ⅱ～Ⅳ期患者占16.7%（12例）。术后6例患者复发，COX回归分析显示BOTs复发率只与初次手术方式有关（P=0.045）。结论：BOTs患者较年轻，术前准确诊断率低，但常早期诊断，预后较好，然而有一定复发率及恶变率，长期随访必不可少。初次手术方式是影响BOTs复发率的最主要因素，但是否影响患者的生存期还需长期密切随访观察。

关键词: 卵巢肿瘤, 复发, 预后, 回顾性研究

Abstract: Objective：To analyze retrospectively those cases of borderline ovarian tumors（BOTs） from Renji Hospital, School of Medicine, Shanghai Jiao Tong University in recent 10 years, including the prognosis of BOTs and factors affecting the prognosis. Methods： A total of 72 patients with BOTs were retrospectively analyzed, from March 2004 to October 2014, including clinical features, diagnosis, treatment and follow-up visit. Results：The mean age at diagnosis was （46.4±17.3） years, including 30（41.7%） patients aged ≤40 years, 22（30.6%） postmenopausal patients, and 47（65.3%） asymptomatic patients. The serum level of CA125 was increased in 29（50.9%） patients, and the level of CA199 in 18（31.6%） patients. The median sonographic dimension of serous BOTs mass （80 mm） was significantly larger than that of mucinous mass (185 mm) （P＜0.001）. 52（72.2%） patients were at stage Ⅰa, while 12（16.7%） at stage Ⅱ-Ⅳ. The recurrence was seen in 6 patients （6/72）, and the recurrence rate was only related to the surgical procedure by the COX regression analysis （P=0.045）. Conclusions：Patient with BOTs are younger, while the preoperative diagnosis rate is not high. The prognosis of BOTs treatment is relatively satisfying if the early diagnosis was achieved. The long-term follow-up visit is essential since BOTs have two reasonably high rates, recurence rate and canceration rate. Surgical procedure is the main factor related to recurrence. It is necessary to keep the long-term follow-up visit, including the survival period and affecting factors, in those BOTs patients after operation.

Key words: Ovarian neoplasms, Recurrence, Prognosis, Retrospective studies