卵巢正常大小的原发性卵巢上皮性癌综合征的临床特点与预后影响因素

Analysis of the Clinical Characteristics and Prognostic Factors with Primary Normal-sized Epithelial Ovarian Carcinoma Syndrome

目的 探讨卵巢正常大小的原发性卵巢上皮性癌综合征的临床特点及预后因素。方法 对 10例患者的病例资料采用回顾性分析方法。结果 本病多发生于 5 0岁以上 ,占 80 % ;以腹胀、食欲差为首发症状 ,占 90 % ;就诊晚 ,易误诊 ,误诊率 40 % ;卵巢均正常大小 ,盆腹腔有广泛种植 ,局部聚集成块 ,占 70 % ;术后残留灶直径 <2 .0cm患者的生存时间高于术后残留灶直径≥ 2 .0cm者 ,但差异无显著性 (P >0 .0 5 )。化学治疗疗程数≥ 6个者生存时间明显高于疗程数 <6个者 (P <0 .0 5 )。本组患者中位生存时间 2 0个月 ,2年存活率 5 0 % ;3年存活率 30 % ;5年存活率 2 0 %。结论 术后残留灶大小可能是影响卵巢正常大小的原发性卵巢上皮性癌综合征患者预后的重要因素。

Objective To investigate the clinical characteristics and prognostic factors of the primary normal sized epithelial ovarian carcinoma syndrome. Methods The clinical records and pathologic slides of the 10 patients who satisfied the diagnostic criteria were retrospectively analyzed. Results The primary normal sized epithelial ovarian carcinoma syndrome was detected in approximately 1.92% of the patients with the epithelial ovarian carcinoma .The age of the patients at diagnosis ranged from 43～70 years, with a median age of 57 years. The most common presentations included anorexia, increasing abdominal girth and awareness of abdominal or pelvic mass. During the exploratory laparotomy although we often discovered the diffuse metastasis throughout the abdominal and pelvic cavity, the ovaries both appeared normal size and had a fine granularity on the external surface. The survival time of patients with remained tumors smaller than 2.0 cm was longer than those with remained tumors larger than 2.0 cm, but the Log rank evaluation indicated χ 2=0.61, P >0.05. The patients who underwent postoperative chemotherapy have been noted to achieve some long term survival. The median survival time was 20 months. Conclusion The results predict that the size of the remained tumors may be one of the important factors to the survival and the disease is sensitive to the postoperative chemotherapy.