卵巢上皮交界性肿瘤34例临床分析

Clinical analysis of 34 cases of ovarian borderline epithelial tumors

[背景]探讨彩色多普勒超声波检查、CA125水平测定及术中冰冻病理检查在卵巢良性及交界性肿瘤鉴别诊断中的应用价值.[病例报告]选择卵巢上皮交界性肿瘤34例及卵巢良性肿瘤36例的临床资料进行回顾性对比分析.卵巢良性肿瘤中壁厚(厚度>2mm)者为11例(30.6%),交界性肿瘤为29例(85.3%);良性中检测到肿瘤囊壁血流信号者为10例(27.8%),交界性肿瘤为26例(76.5%);交界性肿瘤患者中CA125阳性者为24例(70.6%),平均值为(130.81±32.65)U/mL,良性肿瘤患者中CA125阳性者为6例(16.7%),平均值为(24.38±2.27)U/mL;相比较差异均有统计学意义(P<0.01).交界性肿瘤患者中15例行保守性手术治疗,19例行根治性手术治疗;23例行术中冰冻病理检查.良性肿瘤患者中29例行保守性手术治疗,7例行根治性手术治疗;术中冰冻病理检查结果与术后病理检查结果相符.交界性肿瘤患者中4例失访,随访期间仅1例保守性手术治疗后复发恶变,再次手术后行辅助化学治疗,至今肿瘤无复发迹象;其余患者随访至今未见复发.[讨论]彩色多普勒超声波检查及CA125水平测定联合应用对卵巢良性及交界性肿瘤的鉴别诊断有意义.术中冰冻病理检查是术中及时更改术式的有效依据.

BACKGROUND To investigate the differential diagnosis value of Doppler ultrasound and CA125 combined with intraoperative frozen pathology in patients with epithelial ovarian tumors of benign and borderline.CASE REPORTS The clinical data of 34 cases of borderline epithelial tumors and 36 cases of benign ovarian tumors were retrospectively analyzed.〉2mm of tumors wall thickness were in 11cases（30.6%）of benign and in 29cases（85.3%）of borderline.The bloodstream signals in cystic wall were detected in 26cases（76.5%）of borderline and in 10cases（27.8%）of benign by Doppler ultrasound.Positive of CA125 was in 24cases（70.6%,130.81U/mL±32.65U/mL）of borderline and in 6cases（16.7%,24.38U/mL±2.27U/mL）of benign,and it was statistically signifiant differences between borderline and benign（P〈0.01）.Out of 34 cases of borderline epithelial tumors,15 patients were treated by conservative surgeries and 19 patients by radical surgeries,and 23 patients were performed by intraoperative histopathological examination of frozen section.Out of 36 cases of benign ovarian tumors,29 patients were treated by conservative operation and 7patients by radical surgeries.All pathologic diagnoses from the frozen sections of intraoperation and paraffin sections of postoperation were the same results.Out of 34 cases of borderline epithelial tumors,4patients dropped out from the follow-up,1patient developed into malignant change after conservative operation and was accepted by adjuvant chemotherapy after second operation,and the others had no recurrence till now.DISCUSSION Examination of Doppler ultrasound and CA125 are helpful to differential diagnosis of ovarian epithelial borderline and benign tumors,and the intraoperative histopathological examination of frozen section is the effective basis for changing operation pattern in time.