卵巢交界性上皮性肿瘤112例临床分析

The clinical analysis of 112 cases with ovarian borderline epithelial tumors

目的探讨卵巢交界性上皮性肿瘤的临床特点及影响复发的相关因素。方法回顾性分析天津医科大学总医院2000年3月—2015年1月收治的112例卵巢交界性上皮性肿瘤的临床资料。结果 112例患者发病的平均年龄为(50.59±16.90)岁。FIGO临床分期Ⅰ期102例(91.07%),Ⅱ期4例(3.57%),Ⅲ期6例(5.36%);血清肿瘤标志物检查:行CA125检查患者102例,其中指标升高者27例,占26.47%;112例患者均进行手术治疗,年轻患者较年长患者更倾向于选择保守手术治疗;随访患者97例,其中5例复发,复发病例均行非保留生育功能手术。对不同临床病理因素下复发的病例进行对比,病理提示微浸润患者复发率高于无微浸润患者[37.50%(3/8)vs.2.25%(2/89),P=0.004];在浆液性交界性肿瘤患者中,微乳头型交界性浆液性肿瘤的复发率高于非微乳头型[40.00%(2/5)vs.0(0/41),P=0.019];7例行保留生育功能手术的患者成功妊娠。结论对于年轻有生育要求的卵巢交界性上皮性肿瘤患者可选择保留生育功能手术,结局安全有效。对于存在间质微浸润及微乳头型患者要警惕复发的可能。

Objective To determine the clinical features and the factors affecting the recurrence of ovarian borderlineepithelial tumors. Methods A retrospective data of 112 cases with ovarian borderline epithelial tumors admitted in GeneralHospital of Tianjin Medical University from 2000 to 2015 were analyzed. Results The average age was （50.59±16.90） years in112 patients with FIGO stage Ⅰof 102 （91.07%） patients, stage Ⅱof 4 （3.57%） and stage Ⅲof 6 （5.36%）. The serum tumor marker（CA125） was examined in 102 patients, and 27 cases with the elevated indicator （26.47%）. Surgical treatment was performed in112 patients. Younger patients were more likely to choose conservative surgery. Ninety-seven patients were followed up, and 5of them relapsed. Non fertility preserving surgery was performed in patients with recurrence. The recurrence rates of patients withdifferent clinical pathological factors were compared. The recurrence rate was higher in patients with micro infiltration than thatof patients without micro infiltration [37.50% （3/8） vs. 2.25% （2/89）, P=0.004]. And the recurrence rate was higher in patientswith microemulsion type borderline serous tumor than that of patients with non-papillary tumors [40.00%（2/5）vs. 0（0/41）,P=0.019]. Seven patients underwent conservative surgery had normal spontaneous pregnancy. Conclusion The fertility-sparingsurgery can be used as the treatment procedures for young patients, which is safe and effective. It is necessary to be on alert ofrecurrence for the cases with micropapillary pattern, and microinvasive tumor.