儿童青少年卵巢恶性肿瘤临床特点及治疗探讨—25年48例临床资料回顾性分析

CLINICAL ANALYSIS OF OVARIAN MALIGNANT TUMOR IN CHILDREN AND ADOLESCENTS:RETROSPECTIVE STUDY OF 48 CASES DURING 25 YEARS

[目的]探讨儿童青少年卵巢恶性肿瘤临床诊断治疗特点及预后相关因素。[方法]收集我院1980年8月～2005年12月25年间收治的48例18岁以下的卵巢恶性肿瘤患儿的临床资料,按生殖细胞肿瘤、性索间质肿瘤、上皮性肿瘤分为3组,统计分析年龄、病理类型、症状、分期、手术方式、化疗方案、随访结果。[结果]发病年龄4～18岁。恶性生殖细胞肿瘤最多发,共32例,占66.7%。腹部包块、腹痛、腹胀是位居前3位的主要症状。大多数是Ⅰ～Ⅱ期早期病例,共39例,占81%。5年生存率保留生育功能手术患者是72.8%,肿瘤细胞减灭术患者是76.2%,二者差异无统计学意义。分期和病理类型是影响生存率的主要因素。[结论]建议各科医师提高对此类疾病认识,青春期少女应重视体检,尽早发现肿瘤。Ⅰ～Ⅱ期早期病例,可以行保留生育功能手术,术后辅以化疗。儿童青少年卵巢恶性肿瘤有较高的5年生存率。

[ Objective] To determine the serum levels of anti-sperm antibody （AsAb） and tamour necrosis factor α （TNF-α） in infertility patients, in order to explore the function of AsAb and TNF-α in infertility. [Methods] The levels of AsAb and TNF-α in serum samples of 46 cases and 40 normal controls were determined by ELISA. [ Results] The positive rate of serum AsAb in infertility patients was 30.43%. which was significantly higher than that of the normal control group （5%） （P〈 0.05） . The serum TNF-α level in infertility women was 168±15 ng/L. which was obviously higher than that of the normal control group （145±14 ng/L）（P 〈 0.01 ） . The serum TNF-α level in AsAb positive group was significantly higher than that of AsAb negative group （ 177±16 ng/L vs 160±15 ng/L. P 〈 0.01 ） . The serum TNF-α level had positive con＇elation with serum AsAb level （r = 0.778, P 〈 0.01 ） . [ Conclusion] AsAb, TNF-α are important immune factors in infertility, the high level of TNF-α in serum tins close relation to AsAb positive m serum of infertility patients.