46例卵巢恶性畸胎瘤临床病例回顾性分析

发布时间：2018-04-30 02:08

本文选题：卵巢恶性畸胎瘤 + 未成熟畸胎瘤　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:通过对46例卵巢恶性畸胎瘤临床病例资料的整理和回顾性分析,统计并分析卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤恶变的临床特征、病理特征、临床分期、治疗方案及预后情况,同时对影响卵巢恶性畸胎瘤预后的因素进行统计学分析,积累临床经验,为规范化治疗提供依据。方法:收集吉林大学第一医院于2010年1月至2017年1月间收治的46例卵巢恶性畸胎瘤患者的临床病例资料,包括24例卵巢未成熟畸胎瘤和22例卵巢成熟畸胎瘤恶变。所有患者均行手术治疗并经病理确诊,统计并分析卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤恶变的临床特征、病理特征、临床分期、治疗方案及预后情况。运用SPSS19.0(IBM)统计软件进行分析,应用t检验比较卵巢未成熟畸胎瘤与卵巢畸胎瘤恶变两组分组资料的差异。应用Kaplan-Meier生存分析法和Log-rank检验进行卵巢恶性畸胎瘤的预后因素分析,应用χ2检验进行卵巢成熟畸胎瘤恶变的预后因素分析,从而探究卵巢恶性畸胎瘤患者预后相关因素。结果:1.卵巢未成熟畸胎瘤患者的年龄范围7岁—45岁,平均年龄为24.50±9.35岁,中位年龄25.50岁。卵巢成熟畸胎瘤恶变患者的年龄范围23岁—71岁,平均年龄为46.91±13.90岁,中位年龄47.50岁。应用t检验比较卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤恶变的年龄分布差异,显示两者的年龄分布差异有统计学意义(P0.001)。2.卵巢恶性畸胎瘤患者的临床表现无特异性,以腹痛、体检发现多见。3.卵巢未成熟畸胎瘤患者中临床分期I期患者23例(95.83%),IV期患者1例(4.17%)。卵巢成熟畸胎瘤恶变患者中临床分期I期患者18例(81.82%),II期患者1例(4.55%),III期患者3例(13.64%)。卵巢成熟畸胎瘤恶变患者根据恶变病理类型划分,鳞癌8例(36.36%),类癌9例(40.91%),腺癌2例(9.09%),其他3例(13.64%)。4.46例卵巢恶性畸胎瘤患者的肿瘤最大径在2.5cm-22cm之间不等,其中24例卵巢未成熟畸胎瘤患者的肿瘤最大径平均值为10.04±4.18cm,22例卵巢成熟畸胎瘤恶变患者的肿瘤最大径平均值为8.54±4.34cm。应用t检验比较卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤恶变的肿瘤最大径差异,显示两者的肿瘤最大径差异无统计学意义(P=0.2490.05)。5.卵巢恶性畸胎瘤患者按年龄国际分组标准分组,应用Kaplan-Meier法分析,Log-rank检验显示青年组与中年组的生存时间差异有统计学意义(P=0.0450.05),青年组与老年组的生存时间差异有统计学意义(P=0.0020.05)。6.卵巢恶性畸胎瘤患者根据临床分期分为I期(40例)和II期及以上(5例)两组,应用Kaplan-Meier法分析,Log-rank检验显示肿瘤临床分期I期组与II期及以上组的生存时间差异有统计学意义(P0.001)。7.卵巢恶性畸胎瘤患者根据病理类型分为卵巢未成熟畸胎瘤组(24例)和卵巢成熟畸胎瘤恶变组(21例),应用Kaplan-Meier法分析,Log-rank检验显示卵巢未成熟畸胎瘤组与卵巢成熟畸胎瘤恶变组的生存时间差异有统计学意义(P=0.01230.05)。8.应用χ2检验对卵巢成熟畸胎瘤恶变患者的年龄、临床分期、恶变病理类型进行预后因素分析,显示卵巢成熟畸胎瘤恶变的临床分期对预后影响差异有统计学意义(P0.001),年龄、恶变病理类型对预后影响差异无统计学意义。结论:1.卵巢未成熟畸胎瘤多见于青年女性,与卵巢成熟畸胎瘤恶变的年龄分布不同。2.卵巢恶性畸胎瘤的临床表现以腹痛、体检发现多见,临床分期多为I期。3.卵巢成熟畸胎瘤恶变的病理类型以鳞癌、类癌多见,卵巢成熟畸胎瘤恶变的预后与临床分期有关。4.卵巢恶性畸胎瘤的预后与初治年龄、临床分期、病理类型有关,卵巢未成熟畸胎瘤的预后较好。
[Abstract]:Objective: to analyze and analyze the clinical data of 46 cases of ovarian malignant teratoma, and to analyze the clinical features, pathological features, clinical stages, treatment and prognosis of ovarian immature teratoma and mature teratoma of ovary, and to analyze the prognostic factors of ovarian malignant teratoma, and to analyze the factors that affect the prognosis of ovarian malignant teratoma. Clinical experience was accumulated to provide the basis for standardized treatment. Methods: the clinical data of 46 patients with malignant ovarian teratoma treated in No.1 Hospital of Jilin University from January 2010 to January 2017 were collected, including 24 cases of ovarian immature teratoma and 22 cases of malignant ovarian teratoma. All patients underwent surgical treatment and were confirmed by pathology. The clinical features, pathological features, clinical stages, treatment schemes and prognosis of ovarian immature teratoma and ovarian mature teratoma were analyzed and analyzed. The SPSS19.0 (IBM) statistical software was used to analyze the difference between the two groups of ovarian immature teratoma and ovarian teratoma in the two groups. The application of Kaplan-Meie The prognostic factors of ovarian malignant teratoma were analyzed by R survival analysis and Log-rank test. The prognostic factors of ovarian mature teratoma were analyzed by chi 2 test, and the prognostic factors of ovarian malignant teratoma were investigated. Results: the age range of 1. ovarian immature teratoma patients was from 7 to 45 years, with an average age of 24.50 +. The age range of 9.35 years was 25.50 years old. The age range of ovarian mature teratoma patients was 23 years to 71 years old, the average age was 46.91 + 13.90 years and the median age was 47.50 years. T test was used to compare the age distribution of ovarian immature teratoma and ovarian mature teratoma, which showed that the difference of age distribution in two cases was statistically significant (P0.001).2 The clinical manifestations of ovarian malignant teratoma were unspecific, with abdominal pain, 23 patients with.3. ovarian immature teratoma (95.83%), 1 cases (4.17%) in IV stage, 18 (81.82%) of I patients with ovarian mature teratoma, 1 (4.55%) in II stage, 3 in III phase (13.64%). The patients with malignant ovarian teratoma were divided according to the malignant pathological type, 8 cases (36.36%), 9 cases (40.91%), 2 cases of adenocarcinoma (9.09%), and 3 cases (13.64%) of.4.46 cases with malignant ovarian teratoma, the maximum diameter of the tumor was between 2.5cm-22cm, and the average maximum diameter of the 24 cases of ovarian immature teratoma was 10.04 + 4.18. Cm, the maximum diameter of the 22 cases of ovarian mature teratoma was 8.54 + 4.34cm., the maximum diameter difference between the ovarian immature teratoma and the ovarian mature teratoma was compared with the t test. The difference of the maximum diameter between the ovarian immature teratoma and the ovarian mature teratoma was not statistically significant (P=0.2490.05).5. ovarian malignant teratoma patients were divided according to the age international division. Group standard group, Kaplan-Meier analysis, Log-rank test showed that the survival time difference between the young group and the middle-aged group was statistically significant (P=0.0450.05), the difference of survival time between the young group and the elderly group was statistically significant (P=0.0020.05).6. ovarian malignant teratoma patients were divided into I phase (40 cases) and II phase and above (5 cases). The two group, Kaplan-Meier analysis, Log-rank test showed that the difference of survival time between I phase group and II stage and above group was statistically significant (P0.001).7. ovarian malignant teratoma was divided into ovarian immature teratoma group (24 cases) and egg nest mature teratoma malignant change group (21 cases), and Kaplan-Meier method was applied. Analysis, Log-rank test showed that the difference of survival time between the ovarian immature teratoma group and the ovarian mature teratoma group was statistically significant (P=0.01230.05).8. application x 2 test was used to analyze the age, clinical stage and malignant pathological type of ovarian mature teratoma patients, which showed the malignant change of ovarian mature teratoma. There was significant difference in the effect of bed staging on prognosis (P0.001), age and malignant pathological type had no statistical significance on prognosis. Conclusion: 1. ovarian immature teratoma is mostly seen in young women, and the age distribution of ovarian mature teratoma is different from that of.2. ovarian malignant teratoma with abdominal pain, and physical examination is more common. The pathological types of I stage.3. mature teratoma are squamous cell carcinoma. The prognosis of ovarian mature teratoma and the prognosis of ovarian mature teratoma are related to the prognosis of.4. ovarian malignant teratoma, which is related to the primary treatment age, clinical stage and pathological type, and the prognosis of ovarian immature teratoma is better.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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