卵巢上皮性交界性肿瘤210例临床分析

发布时间：2018-05-23 13:47

本文选题：卵巢交界性肿瘤 + 诊断　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨卵巢上皮性交界性肿瘤(Borderline ovarian tumors)临床病理学特征及其复发相关危险因素。方法:回顾性分析山西省肿瘤医院于2001年1月至2015年12月收治的210例BOTs患者的病例资料,分析其临床特点、术前检查、病理学特点、手术方式与复发相关危险因素。结果:1、210例BOTs患者平均发病年龄为41±16岁,有生育要求的有56例。2、49.05%(103/210)的患者表现为腹痛、腹胀,38.57%(81/210)的患者无临床症状在体检时发现。3、术前CA125水平35 IU/ml者91例(48.40%),CA199水平37 IU/ml者53例(30.81%),其升高比例数在组织学类型之间差异有统计学意义(P0.05)。超声显示粘液性包块直径均数为17.23cm,浆液性包块直径均数为8.23cm,两者在包块直径大小、多房性上差异有统计学意义(P0.05)。4、术中冰冻诊断准确率为75.91%(104/137),其中浆液性交界瘤准确率为89.19%(66/74),粘液性交界瘤准确率为60%(33/55)。术中冰冻诊断的准确性在组织学类型之间差异有统计学意义(P0.05)。5、术后最为常见的组织学类型:浆液性交界瘤86例(40.95%),粘液性交界瘤90例(42.86%),混合乳头状瘤21例(10.00%)。病理分期:IA期142例(67.62%),大于IA期68例(32.38%),大部分患者为早期。术后对II期以上、术中有囊肿破裂的47例(22.38%)患者进行化疗。6、术后平均随访时间61.2个月中,有23例患者复发,复发率为11.27%。多因素Logistic回归分析结果显示与复发相关的危险因素有微乳头型、IA期、年龄(P0.05)。术后妊娠率为56.60%。结论:卵巢上皮性交界性肿瘤主要发生在年轻女性,期别相对较早,预后良好。卵巢上皮性交界性肿瘤术前诊断仍然困难。年轻有生育意愿的患者可行保守性手术治疗,术后妊娠率仍较高。对于微乳头型、年轻及高期别的患者,术后复发率高,应密切随访,警惕复发。
[Abstract]:Objective: to investigate the clinicopathological features and risk factors of borderline ovarian tumors in ovarian epithelial sexual intercourse. Methods: the data of 210 patients with BOTs admitted in Shanxi Cancer Hospital from January 2001 to December 2015 were analyzed retrospectively. The clinical features, preoperative examination, pathological features, surgical methods and risk factors related to recurrence were analyzed. Results the mean age of onset of BOTs in 1210 BOTs patients was 41 卤16 years old. No clinical symptoms were found in the patients with abdominal distension of 38.57 / 210. The preoperative CA125 level of 35 IU/ml was found in 91 cases with CA199 level 37 IU/ml in 53 cases with 37 IU/ml, and the proportion of elevation was significantly different between histological types (P 0.05). The mean diameter of mucous mass was 17.23 cm, and the mean diameter of slurry mass was 8.23 cm. The accuracy of intraoperative frozen diagnosis was 75.91%. The accuracy rate of serous borderline tumor was 89.1966 / 74, and the accuracy rate of mucinous borderline tumor was 60.33 / 550.The accuracy of intraoperative frozen diagnosis was 75.91%, and the accuracy of serous borderline tumor was 89.1966 / 74. There was significant difference in the accuracy of intraoperative frozen diagnosis among histological types. The most common histological types were serous borderline tumor in 86 cases, mucinous borderline tumor in 90 cases and mixed papilloma in 21 cases. The most common histological types were serous borderline tumor (n = 86), mucinous borderline tumor (n = 90) and mixed papilloma (n = 21). Pathological stage: IA stage 142 cases (67.62%), larger than IA stage 68 cases (32.38%), most of the patients were early stage. After operation, 47 cases with rupture of cysts above stage II and intraoperative rupture of cysts were treated with chemotherapy .6. the average follow-up time was 61.2 months, 23 cases recurred and the recurrence rate was 11.27%. Multivariate Logistic regression analysis showed that the risk factors associated with recurrence were micropapillary stage IA and age (P0.05). The pregnancy rate was 56.60 after operation. Conclusion: ovarian epithelial borderline tumors mainly occur in young women with relatively early stage and good prognosis. Preoperative diagnosis of ovarian epithelial borderline tumors is still difficult. The pregnant rate of young patients with fertility intention is still high. For other patients with micronipple type, young and high stage, the recurrence rate is high and should be followed up closely and be on the alert for recurrence.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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