卵巢交界性上皮性肿瘤临床分析

The clinical analysis of borderline epithelial ovarian tumors

目的分析卵巢交界性上皮性肿瘤的临床特点、治疗及预后情况,并探讨影响卵巢交界性肿瘤复发及预后的相关因素。方法回顾性分析1980年1月至2009年8月间在北京大学人民医院诊断的卵巢交界性上皮性肿瘤130例,所有患者均经手术治疗及术后病理证实。且经正规肿瘤术后随访12～240个月。结果平均发病年龄为42.3岁;Ⅰ、Ⅱ、Ⅲ期分别为106、6、18例;浆液性、黏液性和其他病理类型各48、63、19例;49.0%(51/104)的患者CA125升高;1%有微乳头浸润,0.05%有浸润性种植;所有患者均进行手术治疗,其中42.3%保留生育功能。复发率为6%(8例),其中18例行卵巢肿物剥除术2例复发,34例单侧或双侧附件切除术未见复发。肿瘤分期手术与一侧附件切除及单纯肿物剥除术的5年及10年存活率分别为100%、100%、95%。结论卵巢交界性肿瘤发病年龄较轻,Ⅰ期为主,黏液性肿瘤多见,预后良好,手术是主要的治疗手段,对早期患者行保留生育功能的手术是安全有效的,术后需长期随访。FIGO分期、微乳头型病变,浸润性种植及初次术后是否残留是影响复发及预后的相关因素。

Objective To investigate the clinical features,management and prognosis of borderline epithelial ovarian tumors（BOT）.To study the factors influencing the recurrence and prognosis of BOT.Methods The data of 130 BOT patients diagnosed by surgery and pathology（Peking University People＇s Hospital,January 1980 to August 2009）were analyzed retrospectively.The postoperative follow-up period ranged from 12 to 240 months.Results The average onset age was 42.3 years old.There were 106 cases of stage Ⅰ,6 cases of stage Ⅱ,18 cases of stage Ⅲ.48 cases were serous,63 cases were mucinous.49.0% patients were with elevated CA125.1% with micropapillary and 0.05% with infiltrative implantation.All patients received operation and 42.3% underwent fertility-sparing procedures.8 cases（6%）relapsed,2 of 18 cases who underwent ovarian cystectomy relapsed.None of the 34 cases who underwent unilateral or bilateral salpingo-oophorectomy relapsed.Five or ten-years survival rate of patients who underwent staging operation,unilateral salpingo-oophorectomy or ovarian cystectomy were 100%,100% and 95%,respectively.Conclusions Onset age of borderline epithelial ovarian tumors was younger,more common in mucinous pathologic type,the majority of patients were stage Ⅰ and the prognosis was good.Surgery is the main effective approach for BOT patients.For those with early stage,fertility-sparing surgery is indicated.Micropapillary,infiltrative implantation,residual disease of primary surgery and FIGO tumor stage are factors influencing the recurrence and prognosis.