卵巢交界性肿瘤79例治疗探讨

Clinical analysis of borderline ovarian tumors in 79 cases

目的探讨卵巢交界性肿瘤(borderline ovarian tumors,BOTs)的治疗。方法对郑州市第三人民医院1990～2010年收治的79例BOTs患者进行回顾性分析,探讨其治疗经过和预后。结果 79例BOTs的病理类型:浆液性40例(50.6%),黏液性26例(32.9%),混合性9例(11.4%),其他类型4例(5.1%)。手术-病理分期:Ⅰa期56例(70.9%),Ⅰb期4例(5.1%),Ⅰc期14例(17.7%),Ⅱ期3例(3.8%),Ⅲ期2例(2.5%)。所有患者均行手术治疗,40例(50.6%)行保留生育功能的保守性手术,其中行囊肿剔除术11例。79例中18例行淋巴结切除术,15例行术后辅助化疗,但早期患者的预后与淋巴结切除及辅助化疗与否关系不大。68例术后随访4～122月,平均72个月,1例Ⅲ期患者术后复发,2年内死于肠梗阻;1例自然死亡。结论对Ⅰ期有生育要求的患者可行保留生育功能手术,Ⅰa期患者行囊肿剔除手术是相对安全的;早期患者不必行淋巴结清扫。对有高危因素的患者,术后短期内适当给予化疗,防止复发是必要的。

Objective To study the clinical features diagnosis and management of borderline ovarian tumors （BOTs）. Methods The data of 79 cases with BOTs confirmed by frozen and wax pathologies in 1990 - y ~ 2010 - y were retrospectively analyzed. Results Pathological type of 79 cases was serous tumor in 40 cases （ 50.6% ） , mucinons tumor in 26 cases （32. 9% ）, mixed tumors in 9 cases （ 11.4% ）, other types of tumors in 4 cases （5. 1% ） respectively. Surgery -pathology stage included stage ] a in 56 cases （70. 9% ）, stage ｜ b in 4 cases （5.1%）, stage I c in 14 cases （ 17. 7% ） ; stage 11 in 3 cases （3.8%） and stage m 2 in cases （2. 5% ）. All patients were given surgical treatment including conservative operation for reserving fertility in 40 cases （50. 6% ） and cyst excision in 11 cases. Among 79 cases, 18 cases were taken the lymphadenectomy, 15 cases were taken postoperative chemotherapy. Conclusion BOTs occur mostly in young patients, with a difficult diagnosis. Surgery is the main method of treatment for BOTs. The choice of surgical method mainly depends on the fertility requirements, age of patients in Stage I. Cyst excision is safety for the patients in Stage Ia. The patients in the early period needn＇ t be taken Lymphadeneetomy. For patients with high risk factors, chemotherapy must be administered shortly after surgery to prevent recurrence.