卵巢肿瘤1201例临床病理分析

Clinicopathological analysis on ovarian tumor of 1201 cases

目的统计大兴区医院近9年手术切除的卵巢肿瘤1 201例,分析其组织学特点,为大兴区妇女保健工作的开展提供科学依据。方法整理2003～2011年手术切除卵巢肿瘤的病理资料,严格按照世界卫生组织卵巢肿瘤分类标准进行病理诊断及分类。结果 1 201例卵巢肿瘤患者中良性肿瘤1 096例(91.26%),交界性肿瘤25例(2.08%),恶性肿瘤80例(6.66%);表面上皮-间质肿瘤484例(40.30%),生殖细胞肿瘤622例(51.79%),性索-间质肿瘤83例(6.97%),转移性肿瘤11例(0.92%),非特殊性软组织肿瘤1例(0.08%)。良性肿瘤中生殖细胞肿瘤占55.88%,表面上皮-间质肿瘤占37.19%;恶性肿瘤中表面上皮-间质肿瘤占63.75%,转移性肿瘤占13.75%。卵巢肿瘤发生于21～40岁者占总数的57.53%,良性肿瘤发生于21～50岁者占78.56%,恶性肿瘤发生于31～60岁者占77.14%;生殖细胞肿瘤在小于20岁的患者中占68.18%;卵巢肿瘤良性双侧发生率为7.76%,其中生殖细胞肿瘤占74.12%,恶性双侧发生率为33.75%,其中上皮性癌占74.07%,转移性肿瘤占25.93%。结论本组调查对象中,卵巢肿瘤中生殖细胞肿瘤最多,其次为表面上皮-间质肿瘤;良性肿瘤中以生殖细胞肿瘤最多,恶性肿瘤中以表面上皮-间质肿瘤最多。卵巢发病年龄以生育期多见,恶性肿瘤发病年龄较良性肿瘤高,年轻患者中尤其小于20岁者多为生殖细胞肿瘤;卵巢肿瘤双侧发生率恶性高于良性,良性多为生殖细胞肿瘤,恶性多为上皮性癌。

Objective To summarize the pathological characteristics of specimens of surgical removal of ovarian tumors in 1201 cases of this hospital in recent 9 years, and to analyze the histological features in order to provide a scientific basis for implementation of women~ health care in this region. Methods The data of surgical removal specimens of ovarian tumor during 2003 to 2011 in this hospital were retrospectively re- viewed and analyzed, according to the WHO ovarian tumor classification criteria for pathological diagnosis and classification. Results Among these 1201 cases of surgical removal specimens of ovarian tumors, there were 1096 cases of benign tumors （91.26%） , 25 cases of borderline tumors （2.08 % ） and 80 cases of malignant tumors （6.66%）. Among them, 484 cases were surface epithelial - stromal tumors （40.67 % ）, 622 cases of germ cell tumors （52.27%）, 83 cases of sex cord - stromal tumor （6.97%）, 11 cases of metastatic tumors （0.92%） and a case of nonspecific soft tissue tumor （0.08%）. Benign germ cell tumor accounted for 55.88%, surface epithelial - mesenchymal tumor accounted for 37. 19%. In malignant tumors, superficial epithelial -mesenchymal tumor accounted for 63.75 %, metastatic tumor accounted for 13.75 %. Ovarian tumors occurred in 21 - 40 years old accounted for 57.53% of the total, benign tumors occurred in 21 to 50 years old accounted for 78.56%, ma- lignant tumor occurred in 31 - 60 years old accounted for 77.14% ; germ cell tumor in less than 20 years old patients accounted for 68.18 %. Inci- dence rate of bilateral benign ovarian tumor was 7.76%, including 74.12% of germ cell tumor, and incidence rate of bilateral malignant tumor was 33.75% including 74.07% of epithelial carcinoma, and 25.93% of metastatic tumor. Conclusion Germ cell tumor is the most common type of ovarian tumor in this hospital, followed by surface epithelial - mesenchymal tumor. Germ cell tumor is the most common type of benign tumors, and surface epithelial - mesenchymal tumor was the most common type of malignant tumors. Ovary tumors are commonly seen in the age of growth period, the age range for onset of malignant tumors is older than benign tumor, especially in young patients less than 20 years old for germ cell tumor. Bilateral ovarian tumors occur as malignant more than benign tumors, germ cell tumors are more frequently seen in benign tumors, epithelial carcinomas are more frequently seen in malignant tumors.