小儿卵巢肿瘤56例临床分析

An analysis on 56 cases of ovarian tumor in children

目的总结小儿卵巢良恶性肿瘤病理特点,以血清AFP作为指标评价治疗效果及预后。方法回顾性分析本院2005年至今手术治疗56例卵巢肿瘤患儿的肿瘤病理特点、肿瘤与年龄的关系以及治疗前后血清AFP值的变化(按良恶性分组并进行组间及组内比较)。结果 56例患儿中,年龄最小4个月,最大17.6岁;良性39例,恶性17例;良性肿瘤中,以卵巢成熟性畸胎瘤(20/39)及囊肿(19/39)多见;恶性肿瘤中,以卵巢未成熟性畸胎瘤(6/19)发病率高。恶性组血清AFP值术前或术后总体AFP值均显著高于良性组(P<0.01)。良性组手术前后血清总体AFP值的变化无统计学意义(P>0.05),而恶性组术后血清总体AFP值较术前下降,差异有统计学意义(P<0.01)。结论小儿卵巢肿瘤中良性者发病率高于恶性;血清AFP值可能作为良恶性鉴别及评估手术疗效的临床指标。手术是有效治疗小儿卵巢肿瘤、改善恶性卵巢肿瘤患儿预后的重要方法。

Objetive To analyze the pathological characteristics of pediatric benign and malignant ovari- an tumor and to evaluate the therapeutic effect and prognosis with serum AFP. Methods Retrospectively ana- lyzed the age and pathological distribution of 56 cases of non-urgent ovarian tumorand their AFP changes overall at preoperation and postoperation from 2005. Results As far as the 56 cases of ovarian tumor, the lowest age was 4 month-old and the maximal age was 17.6 year-old ; 39 cases were benign and 17 cases were malignant. The maturity teratoma （20/39）and ovarian cysts（19/39） were common in benign ovarian tumor; non -maturi- ty teratoma（6/19） was high prevalence in malignant ovarian tumor. The serum AFP value overall in children with malignant ovarian tumor was higher to the children with benign ovarian tumor （ P 〈 0.01 ）. There was no statistical significance about postoperative or preoperative serum AFP value change in benign ovarian tumor o- verall, For the malignant ovarian tumor, postoperative serum AFP value overall was down to compared with pre- operation （P 〈 0.01 ）. Conclusions The overall mobidity of benign tumor is higher than malignant tumor; Serum AFP value may be as clinical indicators for identification of benign and malignancy, or evaluation of cura- tive effect of surgery. Surgery is still the effective way to treat or cure children＇ s ovarian tumor,also to improve the prognosis.