交界性卵巢肿瘤临床、病理特征及术式和复发相关因素分析

Analysis of clinical,pathological features,surgical and recurrence related factors of borderline ovarian tumors

目的本文旨在分析交界性卵巢肿瘤(Borderline Ovarian Tumor,BOT)临床、病理特征,评价治疗和复发影响因素。方法回顾性分析84例BOT临床和病理资料及手术和预后信息。结果84例BOT患者血清CA125、CA19-9和CEA的中值±四分位距分别是(85.5±246.2)U/ml、(26.4±91.7)U/ml和(1.55±3.67)ng/ml。组织学类型以浆液性和黏液性最为多见(77例,91.7%),FIGO Ⅰ期占比74.4%,腹膜种植发生率42.9%,癌变发生率17.9%。黏液性与浆液性相比,前者首发症状多表现为腹胀和腹围增大(42.1%vs.15.4%),有较高的血清CEA水平(1.81ng/ml±6.18ng/ml vs.0.87ng/ml±1.23ng/ml),后者较隐匿,多体检发现(48.7%vs.26.3%),血清CA125水平更高(211.8U/ml±676.19U/ml vs.68.75U/ml±92.16U/ml)。BOT的FIGO较晚分期与腹膜种植发生和癌变密切相关(P<0.05)。肿瘤复发与血清CEA水平、癌变及FIGO分期相关(P<0.05)。结论FIGO分期是BOT复发独立危险因素;高水平血清CEA可能是黏液性BOT复发重要危险因素。

Objective This study was to analyze the clinical and pathological features and to evaluate the factors in treatment and recurrence of borderline ovarian tumors (BOT).Methods The clinical and pathological data,surgical and prognostic information of 84BOT cases were retrospectively analyzed.Results The median ±interquartile range of serum CA125, CA19-9 and CEA was respectively (85.5±246.2)U/ml,(26.4±91.7)U/ml and (1.55±3.67)ng/ml.The most common histological types were serous and mucinous (77cases,91.7%).74.4%patients were FIGO stage I.Peritoneal implantation occurred in 36patients (42.9%)and the canceration rate was 17.9%(15/84).Compared with serous BOT,the first symptoms of mucous BOT were abdominal distension and increased abdominal circumference (42.1%vs.15.4%),while the latter was more insidious(48.7%vs.26.3%).We observed the higher level of serum CEA (1.81 ng/ml ±6.18ng/ml vs. 0.87ng/ml ±1.23ng/ml)in mucous BOT and higher level of serum CA125(211.8U/ml±676.19U/ml vs.68.75U/ml±92.16U/ml)in serous BOT.The later FIGO stage of BOT was closely related to peritoneal implantation and carcinogenesis (P <0.05).The recurrence was associated with serum CEA level,carcinogenesis and FIGO stage (P <0.05).Conclusion FIGO staging is an independent risk factor for recurrence of BOT,and high serum CEA level may be an important hazardous risk of the recurrence of mucous BOT.