卵巢库肯勃瘤67例临床病理分析

Clinicopathologic analysis of 67 cases with krukenberg tumors of the ovary

目的：探讨分析卵巢库肯勃瘤的临床病理特点及其预后。方法回顾性分析2009年6月-2012年6月重庆市万盛经济开发区人民医院和山东省医学科学院附属医院收治的67例卵巢库肯勃瘤患者临床病理资料，病理检测采用HE染色方法，观察年龄、月经状况、临床症状、治疗情况及方法、生存时间、病理结果、原发肿瘤位置、原发肿瘤分化程度、卵巢转移灶形态、术中发现合并其他部位转移情况、术前诊断误诊为原发卵巢肿瘤情况等。结果43例（64.1%）原发肿瘤被证实起源于胃癌，12例来源于结肠癌，9例来源于直肠癌，2例源于乳腺癌，膀胱源于癌1例。其中，36例（53.7%）涉及双侧卵巢，单侧卵巢转移患者26例，右侧15例，左侧11例，单侧和双侧无法明确证实者5例。13例患者伴卵巢外腹膜种植。卵巢转移肿瘤最大直径29厘米，中位直径8.7 cm，直径小于5 cm者7例（10.4%），直径5-10 cm者42例（62.6%）。绝经前卵巢库肯勃瘤发病率明显高于绝经后（P〈0.05）。随访67例患者死亡时间1-45个月，中位生存期11.2个月，42例患者（62.6%）在1年内死亡。只有3例（4.5%）库肯勃瘤患者诊断后存活超过3年。结论卵巢库肯勃瘤患者的预后均较差。妇科检查及鉴别诊断对卵巢转移癌患者的诊断和治疗及其重要，大多数卵巢库肯勃瘤患者初次诊断时伴有腹部或妇科疾病，避免诊断和治疗中的误诊误治对患者的预后至关重要。

Objective To investigate the clinicopathologic characteristics and prognosis analysis of Krukenberg tumors of ovary. Methods Clinicopathologic data of 67 cases of ovarian Krukenberg tumors from June 2009 to June 2012 in the People＇s Hospital of Wansheng Economic Development Zone and the Affiliated Hospital of Shandong Academy of Medical Sciences were analyzed retrospectively. Pathological examination using HE （hematoxylin-eosin） staining method. The age, menopausal status, clinical symptoms, treatment, survival time, pathological results, location of prima-ry tumor, primary tumor differentiation degree, morphology of ovarian metastasis, intraoperative findings combined with the other parts of the metastasis, the preoperative misdiagnosis as the primary ovarian tumor were observed. Results 43 cases （64.1%） of metastatic ovarian tumor were confirmed originated from the gastric cancer, 12 cases from colon can-cer, 9 cases from colorectal cancer, 2 cases from breast cancer, 1 case from bladder cancer. Among them, 36 cases （53.7%） relates to the bilateral ovaries, 26 patients with unilateral ovarian metastasis, 15 cases of right side, 11 cases of left side, 5 cases could not be clearly confirmed in unilateral or bilateral. 13 cases with extraovarian peritoneal metas-tasis. The maximum diameter of metastatic ovarian tumor was 29 cm, median diameter of 8.7 cm, only 7 cases （10.4%） of the diameter of the metastatic ovarian tumor were less than 5 cm, the diameter of 42 cases （62.6%） were between 5 cm and 10 cm. the morbidity of Krukenberg in premenopausal patients were significantly higher than that in post-menopausal patients （P〈 0.05）. 67 patients were followed up in the time of death for 1 month to 45 months, median survival time was 11.2 months, 42 patients （62.6%） died in 1 year. Only 3 cases （4.5%） with Krukenberg tumor diagno-sis survived more than 3 years. Conclusion The prognosis of patients with ovarian Krukenberg tumor are poor. Gynae-cology examination is very important to diagnosis and treatment of ovarian metastasis cancer, many ovarian Krukenberg tumors patients have abdominal or gynecologic complaints when initial diagnosis, avoid misdiagnosis and mistreatment are very important to prognosis.