原发于胃肠道的卵巢转移癌22例临床分析

A Clinic Analysis of Metastatic Ovarian Carcinoma from the Stomach or Colon Tumor

[目的]研究卵巢转移癌的临床特点、治疗措施及预后的影响因素。[方法]回顾性分析了自1964年1月～1998年3月收治的卵巢转移癌患者共22例。[结果]本组16例原发肿瘤为胃癌 ,6例为结肠癌。生存时间8例≤3个月 ,8例3～6个月 ,6～12个月3例 ,>2年3例 ,最长时间为38个月 ,总的2年生存率为13 6 %(3/22)。22例患者中来源于结肠癌的卵巢转移癌的2年生存率为33 3 %(2/6) ,明显高于胃癌的6 2%(1/16)(P<0 05)。卵巢转移癌中 ,印戒细胞癌的2年生存率11 1%低于非印戒细胞癌的15 4%(P<0 05)。卵巢癌细胞减灭术后 ,残留肿瘤≤2cm者预后比残余肿瘤>2cm者好(P<0.05)。[结论]卵巢转移癌患者一般比原发卵巢癌患者年轻 ,对疑为卵巢转移癌的患者应注意行胃肠镜检查 ,满意的肿瘤细胞减灭术、规范的化疗有助于改善患者的预后。对女性胃肠癌患者行手术时应谨慎探查双侧卵巢 ,必要时行卵巢冰冻切片检查 。

To investigate the clinical character,treatment and prognosis of metastatic ovarian carcinoma(MOC).Twenty two cases of MOC in Jan.1964 to Mar.1998 were eligible for the retrospective study.Of 22 cases,the survival time was ≤3 months in 8 cases, ≤6 months in 8 cases, ≤1 year in 3 cases and >2 years in 3 cases.The longest survival time was 38 months,and overall 2 year survival rate was 13 6%(3/22).The primary carcinoma of MOC was stomach tumors in 16 cases and colon tumors in 6 cases .Two year survival rate of patients with metastatic tumor from colon was significantly higher (33 3%,2/6) than that of patients with metastatic tumor from stomach (P<0 05).Two year survival rate of non signet ring cell carcinoma was significantly higher (15 4%) than that of signet ring cell carcinoma (P<0 05).The prognosis of residual tumor≤2cm was better than that of residual tumor >2cm(P<0 05).[Conclusion]Patients with MOC were usually younger than patients with primary ovarian carcinoma.Radical surgery and chemotherapy are justified to patients with MOC.The stomachoscopy and colonoscopy must be offered to the patient who is suspected to have MOC.The prophylactic oophorectomy should be individulized for the patients with stomach or colon tumor.