年轻卵巢恶性肿瘤患者139例临床分析

Clinical analysis of ovarian malignancies in 139 young female patients

目的探讨年龄30岁以下卵巢恶性肿瘤患者的临床特点、病理类型、治疗方案及预后。方法回顾性分析2010年1月至2015年1月间就诊于中国人民解放军总医院、年龄位于30岁以下的139例卵巢肿瘤患者的临床资料,对其发病特征,病理类型,手术方式,术后辅助化疗进行分析。结果有明显临床症状就诊者占87.77%(122/139),卵巢恶性肿瘤病理分类包括上皮性肿瘤58例(41.73%)、生殖细胞肿瘤79例(56.83%)、性索间质肿瘤1例(0.72%)、转移性肿瘤1例(0.72%)。手术病理分期:Ⅰ期103例,Ⅱ期13例,Ⅲ期18例,Ⅳ期5例。109例行保留生育功能手术。127例行术后辅助化疗。随访超过24个月的患者中65例无瘤生存,复发8例,5例死亡;66例月经化疗后恢复正常,33例有生育计划的患者中21次妊娠,11例足月分娩。结论卵巢癌病理类型与年龄相关,幼女及青少年是生殖细胞为主。卵巢恶性肿瘤临床手术病理分期早期,手术应尽可能保留生育功能。应重视年卵巢疾病的临床表现并定期妇科检查,早期诊治可有效改善预后。

Objective To analysis the characteristics and optimal treatments of ovarian malignancies in young women aged less than 30 years.Methods Retrospective analysis was performed for the clinical data of ovarian malignancies in young women aged less than 30 years who were treated in Chinese PLA General Hospital from January2010 to January 2015.Results 87.77%（122/139）patients have obvious clinical symptoms.Ovarian malignant tumor pathologic classification including 58 epithelial tumors,79 germ cell tumors,1sex cord stromal tumor and 1metastatic ovarian tumor.Surgical pathology staging：103cases in stageⅠ,13inⅡ,18inⅢand 5in stageⅣ.109 cases underwent preserving fertility function surgery.127 cases took postoperative adjuvant chemotherapy.Among those whose follow-up time more than 24 months,8cases recurred,65 cases were disease-free and 5dead.66 patients had normal menstruation period after chemotherapy,33 of them had fertility desire and 21 pregnancies achieved with 11full-term birth.Conclusions Germ cell tumor was the most common ovarian malignancies in young women under 30 years old.Early clinical surgical pathological staging ovarian malignant tumor can best be treated with conservative surgery,followed by adjuvant chemotherapy.