卵巢交界性肿瘤18例分析

Clinical analysis of borderline ovarian tumors in 18 cases

目的探讨卵巢交界性肿瘤的合理治疗方式。方法对1993年至2005年我院收治的18例卵巢交界性肿瘤进行回顾性分析。结果组织学类型黏液性10例（55.6％），浆液性6例（33．3％）。临床分期Ⅰ期11例（61．1％），Ⅱ期5例（27．8％），Ⅲ期2例（11．1％），无Ⅳ期患者。行单侧附件切除术8例，子宫和单侧附件切除术4例，子宫和双侧附件切除术加（或不加）大网膜、阑尾切除术6例；术后未行化疗5例，余13例术后均进行了化疗。病例随诊1—12年，随诊期间18例均存活。结论黏液性瘤所占比例明显高于浆液性瘤。手术治疗是交界性肿瘤有效的治疗手段。对Ⅰ期有生育要求的患者应尽量保留生育功能．对年轻患者应至少保留一侧卵巢。卵巢交界性肿瘤病人术后化疗与否不影响预后，尤其是Ⅰ期病人。CA-125对交界性肿瘤监测有一定意义。

Objective To investigate the rational management of borderline ovarian tumors. Methods Eighteen patients with borderline ovarian tumors admitted to our hospital from 1993 to 2005 were retrospectively studied. Results Histological type,mucous 10 （55.6%） and serous 6 （33.3%）. Stage ： Ⅰ 11 （ 61. 1% ）, Ⅱ 5 （ 27.8% ）, Ⅲ 2 （ 11.1% ）, Ⅳ 0%. Unilateral salpingo-oopborectomy was performed in 8 patients and hysterectomy and unilateral salpingo-oophorectomy in 4 patients. Hysterectomy and bilateral adnexectomy and （or not） omentectomy, appendectomy in 6 patients. Thirteen patients were treated with chemotherapy after operation. Five patients were not treated with chemotherapy. All the patients were followed up for 1 to 12 years. All the patients survived during follow up. Conclusions The proportion of mucous tumor is higher than that of serous tumor in this group. Surgery is the proved only effective treatment of borderline ovarian tumor,conservative sugery with unilateral oophorectomy might be indicated for stage Ⅰ case wbo desires to remain fertility, and at least contralateral ovary should be reserved for younger patients. Chemotherapy after operation can not improve the prognosis of borderline ovarian tumor,especially the stage Ⅰ.CA-125 is effective in monitoring of borderline ovarian tumor.