辅助生殖技术中发现上皮性卵巢癌的病例分析和文献复习

发布时间：2018-03-18 14:12

本文选题：上皮性卵巢癌　切入点：辅助生殖技术　出处：《浙江大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探索辅助生殖技术过程中发现上皮性卵巢癌的临床特点和诊治经验。方法：回顾我院2012年1月～2016年2月在辅助生殖技术过程中发现的上皮性卵巢癌2例,并通过文献检索收集9例个案,提取相关信息。结果：在初次接受ART治疗后半年内发现卵巢癌者3例,考虑与辅助生殖技术不相关；接受ART次数小于等于4次者4例,卵巢癌病理类型均为浆液性腺癌,平均发病年龄27.8±3.1岁。接受ART治疗次数大于等于5次者4例,病理类型均为子宫内膜样腺癌,平均发病年龄39±1.2岁,其中1例不孕类型为排卵障碍,3例为男方不孕。选择保留生育功能者共4例,1例为IC1期、G1分化子宫内膜样腺癌,行双侧附件切除而保留子宫；1例为IA期、G1分化浆液性腺癌,行单侧附件切除术、保留子宫；1例为IC期、子宫内膜样腺癌,1例为孕中期发现的浆液性腺癌行单侧附件切除术。根据已有数据,随访时间6个月～6年,均为无瘤生存,未随访到死亡或复发病例。结论：辅助生殖技术前应全面检查排除卵巢癌,反复多次的ART治疗可能会增加卵巢子宫内膜样腺癌的发生风险,在辅助生殖技术发现的卵巢癌行保留生育功能手术应慎重。
[Abstract]:Objective: to explore the clinical features, diagnosis and treatment of epithelial ovarian cancer in the course of assisted reproductive technique. Methods: two cases of epithelial ovarian cancer from January 2012 to February 2016 in our hospital were reviewed. The results showed that ovarian cancer was found in 3 cases within six months after initial ART treatment, which was not related to assisted reproductive technology, and 4 cases received ART less than 4 times. The pathological types of ovarian cancer were serous adenocarcinoma with an average onset age of 27.8 卤3.1 years. 4 cases were treated with ART for more than 5 times. The pathological types were endometrioid adenocarcinoma with an average onset age of 39 卤1.2 years. One case of infertility was ovulation disorder 3 cases were male infertility, 4 cases were selected to retain fertility function, 1 case was endometrial adenocarcinoma differentiated from IC1 stage G 1, and 1 case was treated with bilateral appendage resection and 1 case with IA stage G 1 differentiated serous adenocarcinoma. Unilateral appendectomy was performed in 1 case of IC stage and 1 case of endometrial adenocarcinoma was found in the second trimester of pregnancy. According to the available data, the follow-up time was 6 months to 6 years, and all of them were tumor-free. Conclusion: ovarian cancer should be ruled out before assisted reproductive technique. Repeated ART treatment may increase the risk of endometrioid adenocarcinoma of ovary. Surgery for preserving reproductive function in ovarian cancer found by assisted reproductive technology should be cautious.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.31;R714.8

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