42例卵巢恶性生殖细胞肿瘤临床特征及预后分析

发布时间：2018-04-29 20:52

本文选题：卵巢恶性生殖细胞肿瘤 + 混合性生殖细胞肿瘤　；参考：《实用妇产科杂志》2015年01期

【摘要】：目的:探讨卵巢恶性生殖细胞肿瘤的临床特征与预后的关系。方法:收集我院2006年8月至2012年2月收治的42例卵巢恶性生殖细胞肿瘤的临床资料,分析其肿瘤类型、分期、治疗方案等预后相关因素,研究其临床特征与不良预后的关系。结果:42例卵巢恶性生殖细胞肿瘤包括混合性生殖细胞肿瘤16例(38.1%)、未成熟畸胎瘤12例(28.6%)、无性细胞瘤6例(14.3%),卵黄囊瘤4例(9.5%)、绒毛膜癌1例(2.4%)及胚胎癌1例(2.4%)等。42例患者全部进行手术治疗,其中30例在初次手术中保留了生育功能,34例在术后给予BEP方案(博来霉素+依托泊苷+顺铂)或BVP方案(博来霉素+长春新碱+顺铂)化疗。2年生存率97.5%(39/40),死亡1例(Ⅳ期混合性生殖细胞肿瘤),复发率37.5%(15/40),混合性生殖细胞肿瘤复发占66.7%(10/15);5年生存率88.2%(15/17),死亡2例(均为恶性混合性生殖细胞肿瘤)。不同病理分期、肿瘤直径、肿瘤类型和手术方式的5年生存率比较,差异均无统计学意义(P0.05)。结论:保留生育功能手术及规范化的BEP或BVP方案化疗,5年总体生存率较高,但混合性生殖细胞肿瘤预后相对较差。卵巢恶性生殖细胞肿瘤的病理分期、肿瘤直径及肿瘤类型与生存率的关系还需进一步研究。
[Abstract]:Objective: to investigate the relationship between clinical features and prognosis of ovarian malignant germ cell tumor. Methods: the clinical data of 42 cases of ovarian malignant germ cell tumor admitted in our hospital from August 2006 to February 2012 were collected, and the prognostic factors such as tumor type, stage and treatment plan were analyzed, and the relationship between clinical features and poor prognosis was studied. Results of 42 cases of malignant germ cell tumor of ovary, 16 cases were mixed germ cell tumor, 12 cases were immature teratoma, 6 cases were asexual tumor, 4 cases were yolk sac tumor, 1 case was choriocarcinoma, and 1 case was embryonic carcinoma. All patients underwent surgical treatment. Thirty of them had retained their fertility function during the first operation. 34 cases received BEP regimen (bleomycin etoposide cisplatin) or BVP regimen (bleomycin vincristine cisplatin) after operation. The 2-year survival rate was 97.5- 39% 40% and the death was 1%. The recurrence rate of mixed germ cell tumor was 37.5%, the recurrence rate of mixed germ cell tumor was 66.710 / 15 / 15, the 5-year survival rate was 88.2% / 17%, and 2 cases were dead (all malignant mixed germ cell tumors). There was no significant difference in 5-year survival rate among different pathological stages, tumor diameter, tumor types and surgical methods. Conclusion: the 5-year overall survival rate of fertility preserving surgery and standardized BEP or BVP regimen chemotherapy is higher, but the prognosis of mixed germ cell tumor is relatively poor. The relationship between pathological stage, tumor diameter, tumor type and survival rate of ovarian malignant germ cell tumor needs further study.
【作者单位】：四川大学华西第二医院;
【分类号】：R737.31

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