卵巢成熟畸胎瘤恶变的预后规律

Biological Features and Prognosis of Teratomas with Malignant Transformation

目的 探讨卵巢成熟畸胎瘤恶变的生物学特性及预后规律。方法 对 18例卵巢成熟畸胎瘤恶变的生存率、平均缓解时间、复发转移规律及预后影响因素进行分析 ,以同期治疗的 35例卵巢未成熟畸胎瘤作对照。结果 卵巢成熟畸胎瘤恶变的中位发病年龄较未成熟畸胎瘤晚 10年 ,3、5、10年生存率较卵巢未成熟畸胎瘤低 (P <0 .0 5 ) ,术后复发转移率较卵巢未成熟畸胎瘤高(P <0 .0 5 ) ,术后平均缓解时间较未成熟畸胎瘤短 (P <0 .0 5 )。行全子宫双附件及大网膜切除较单侧附件切除术者平均缓解时间长 (P <0 .0 5 ) ,术后 7天内开始化疗及术后无残留者平均缓解时间长 (P <0 .0 5 ) ,5年生存率高 (P <0 .0 5 )。结论 卵巢成熟畸胎瘤恶变发病年龄较未成熟畸胎瘤晚 10年 ,且恶性度高 ,术后易发生复发转移。行基本卵巢癌手术术式、术后 7天内开始化疗、术后无肿瘤残留者可显著提高疗效。

Objectives To analyse the biological feature and the prognostic rule of teratomas with malignant transformation.Methods A total of 18 cases of teratomas with malignant transformation entered this study.The survival rate,average remission time,recurrence and the influencing factors of prognosis were analysed and compared with 35 cases of ovarian immature teratomas.Results The median age was later 10 years in teratomas with malignant transformation than in those with immature teratomas.The 3 year,5 year and 10 year survival rate was lower(P<0.05) and recurrence rate was higher(P<0.05) and the average remission time was shorter(P<0.05) in teratomas with malignant transformation.The patients who underwent total abdominal hysterectomy,bilateral salpingo-oophorectomy,and omentectomy had longer average remission time than those who underwent the unilateral salpingo-oopherectomy(P<0.05).The average remission time was longer(P<0.05),the 5 year survival rate was higher(P<0.05) in patients who received chemotherapy within 7 days after operation and in patients who had no tumor residual.Conclusion Teratomas with malignant transformation have a high recurrence rate and are more aggressive than immature teratomas of ovary.It will improve the theroputic effect considerably to perform the basic surgical operation,to start chemotherapy within 7 days after operation,to have no tumor residual.