卵巢交界性肿瘤的临床特点及预后影响因素分析

The analysis of clinical features and prognostic factors of borderline ovarian tumors

目的观察不同病理类型卵巢交界性肿瘤的临床特点,分析影响预后的相关因素。方法回顾性分析该科治疗的60例卵巢交界性肿瘤患者的临床资料,根据病理分型分为浆液组和黏液组,比较两组患者的临床特点,探讨影响预后的临床因素。结果 60例卵巢交界性肿瘤以浆液性(n=22,36.7%)和黏液性(n=34,56.6%)为主,共占93.3%。浆液组和黏液组肿瘤大小、双侧卵巢累及率、肿瘤具多房性、呈乳头状、癌抗原(CA)125与CA19-9比较差异有统计学意义(P<0.05)。56例患者均获得随访,5年总生存率和无瘤生存率分别为96.8%和94.2%。对5年无瘤生存率进行单因素分析,结果提示年龄、肿瘤大小、病理类型、是否绝经、手术方式、术后化疗、CA125、CA19-9等因素与患者预后无关;而国际妇产科联盟(FIGO)分期、微浸润、腹膜种植与预后有关(P<0.05)。多因素Logistic回归分析显示,FIGO分期低的患者预后更好(OR=0.348,P<0.05),而微浸润(OR=8.458,P<0.05)、腹膜种植(OR=7.109,P<0.05)是影响预后的危险因素。结论卵巢交界性肿瘤发病年龄轻,预后良好,且浆液性与黏液性卵巢交界性肿瘤具有一定的不同点。肿瘤FIGO分期、微浸润、腹膜种植可影响预后,对存在这些高危因素的患者应长期随访。

Objective To observe the clinical features of different pathological borderline ovarian tumors and evaluate its prog-nostic factors .Methods The clinical data of 60 patients were retrospectively analyzed .Based on different histological types ,these patients were divided into serous borderline ovarian tumors group and mucins borderline ovarian tumors group .The clinical features was compared .Results 60 cases of epithelial borderline ovarian tumors contained 22（36 .7% ） serous borderline ovarian tumors and 34（56 .6% ） mucins borderline ovarian tumors .The tumor size ,ratio of bi-laterality ,multi-locular cyst ,papillary patterns ,level of CA-125 or CA19-9 had significant differences between the two groups（P＆lt;0 .05） .56 patients were followed up ,the 5-year overall survival and disease-free survival were 96 .8% and 94 .2% ,respectively .Univariate analysis of 5 years disease-free survival showed that ,age ,tumor size ,histological types ,menopause ,operation types ,chemotherapy and level of CA-125 or CA19-9 were irrelevant to prognosis of patients ,and FIGO stage ,micro-invasion ,peritoneal implants were relevant factors to prognosis .Multivariate analyses showed that ,the patients with low stage of FIGO （OR=0 .348 ,P＆lt;0 .05） had better prognosis ,while the patients with micro-inva-sion（OR= 8 .458 ,P＆lt; 0 .05） ,peritoneal implants （OR= 7 .109 ,P＆lt; 0 .05） had worse prognosis .Conclusion Borderline ovarian tumors frequently affected younger patients and has an excellent prognosis .there were some different clinical characteristics be-tween serous borderline ovarian tumors and mucins borderline ovarian tumors .All patients with borderline ovarian tumors should follow-up ,especially these who had high risks as micro-invasion ,peritoneal implants and high FIGO stage .