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卵巢卵黄囊瘤9例临床分析 被引量:3

Clinical Analysis of 9 Cases of Ovarian Yolk Sac Tumor
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摘要 目的:探讨卵巢卵黄囊瘤(ovarian yolk sac tumor, OYST)这一罕见疾病的诊断、治疗及预后。方法:对天津市中心妇产科医院2004年10月至2014年10月收治并经过手术和病理诊断确诊的9例OYST患者的临床资料进行分析、探讨和总结。结果:9例患者年龄17~60岁,中位年龄21岁。出现腹痛症状的患者5例,其余4例患者出现不同程度腹部坠胀现象,早期患者(6例IC期)占66.7%,晚期患者(1例IIIA期,2例IIIC期)占33.3%。手术前所有患者甲胎蛋白(alpha-fetoprotein,AFP)水平均高于正常值,对9例患者均施行手术治疗,对提出保留生育功能8例患者行保留生育功能手术方案,其中2例患者术后肿瘤未控,再次行根治性肿瘤细胞减灭术。1例绝经期患者直接行根治性手术。术后所有患者均采用BEP[博来霉素(bleomycin)、依托泊苷(etoposide)、顺铂(platinol)]方案进行辅助化疗,2例再次肿瘤细胞减灭术患者因AFP下降不满意,其中1例改为IEP[异环磷酰胺(ifosfamide)、依托泊苷(etoposide)、顺铂(platinol)]方案化疗,另1例改为VeIP方案化疗[长春新碱(vinblastine)、异环磷酰胺(ifosfamide)、顺铂(platinol)]。中位随访时间132月(80~178月),1例IIIA期患者死亡,2例IIIC期及6例IC期患者均无瘤生存,接受保留生育功能手术的6例患者中3例已正常生育。结论:卵巢卵黄囊瘤是一种来源于原始生殖细胞的高度恶性生殖细胞肿瘤,发病率极低,多见于低年龄的女性。血清AFP作为一种特异性较高的OYST标志物,对OYST的诊断具有肯定的价值。OYST对化疗非常敏感,对提出保留生育功能的患者在术中采取相应术式,术后可采用合理的BEP方案进行辅助化疗。 Objective:To investigate the diagnosis,treatment and prognosis of a rare disease,ovarian yolk sac tumor(OYST).Methods:The clinical data of 9 patients with OYST admitted to Tianjin Central Hospital of Gynecology and Obstetrics from October 2004 to October 2014 were collected,a retrospective analysis was made and a conclusion was drawn.Results:The 9 patients were 17-60 year olds,and the median age was 21 years.Five patients had abdominal pain and 4 patients had abdominal distension.Six patients(66.7%)were in an early stage(IC),3 patients(33.3%)were in the late stages(one case in stage IIIA,two cases in stage IIIC).The preoperative alpha-fetoprotein(AFP)level of all patients was in an above-normal level.All patients underwent surgeries,and those for 8 patients were adjusted as their demand for fertility preservation.The tumor of 2 patients was not controlled after operation,and they underwent cytoreductive surgery.One menopausal patient underwent radical surgery.All patients received chemotherapy with bleomycin,etoposide and platinol(know as the BEP regimen)after operation.The AFP of 2 patients did not decrease to a satisfactory level after the second cytoreductive surgery.One patient thus received chemotherapy with ifosfamide,etoposide and platinol(know as the IEP regi-men),and the other received chemotherapy with vinblastine,ifosfamide and platinol(know as the VeIP regimen).The median follow-up time was 132(80-178)months.One patient with stage IIIA OYST died.Two patients with stage IIIC OYST and 6 patients with stage IC OYST had tumorfree survival.Three of the 6 patients with fertility-sparing surgery achieved fertility preservation.Conclusion:OYST is an ovarian malignancy originating from genital cells.It is relatively common in young women with low incidence.Serum AFP,as a OYST marker with high specificity,is of positive value in the diagnosis of OYST.OYST is highly sensitive to chemotherapy.Fertility-sparing surgery is adopted for patients with demand for fertility preservation,and BEP regimen is used for adjuvant chemotherapy after operation.
作者 张娜 高燕 籍海虹 张佩瑾 曲芃芃 Zhang Na;Gao Yan;Ji Haihong;Zhang Peijin;Qu Pengpeng(Department of Gynecologic Oncology,Tianjin Central Hospital of Gynecology and Obstetrics,Tianjin 300100,China)
出处 《肿瘤预防与治疗》 2020年第5期433-438,共6页 Journal of Cancer Control And Treatment
关键词 卵巢卵黄囊瘤 甲胎蛋白 保留生育功能手术 化疗 Ovarian yolk sac tumor Alpha-fetoprotein Fertility-sparing surgery Chemotherapy
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  • 1彭光银,范钦和,陈炳宇.卵黄囊瘤临床病理分析[J].河北医学,2006,12(3):273-275. 被引量:3
  • 2Eisenkop SM, Spirtos NM, Lin WCM. Optimal cytoreduction for advance epithelial ovarian cancer: a commentary [J]. Gynecol Oncol,2005,103 ( 1 ) :329 -335.
  • 3Cicin I,Saip P, Guney N, et al. Yolk sac tumours of the ovary: evaluation of clinicopathological features and prognostic factors [ J ]. Eur J Obstet Gynecol Reprod Biol, 2009,146(2) :210 -214.
  • 4Tong X,You Q, Li L, et al. Prognostic factors of patients with ovarian yolk sac tumors:a study in Chinese patients [J]. Onkologie,2008,31 (12) :679 -684.
  • 5Lee KH, Lee IH, Kim BG, et al. Clinicopathologlc characteristics of malignant germ cell tumors in the ovaries of Korean women:a Korean Gynecologic Oncology Group Study [J]. Int J Gynecol Cancer,2009,19( 1 ) :84 - 87.
  • 6Low JJ, Pen-in LC, Crandon AJ, et al. Conservative surgery to preserve ovarian function in patients with malignant ovarian germ cell tumors. A review of 74 cases [ J ]. Cancer,2000,89(2) :391 - 398.
  • 7Ayhan A,Taskiran C, Bozdag G, et al. Endodermal sinus tumor of the ovary: the Hacettepe University experience [J]. Eur J Obstet Gynecol Reprod Biol,2005,123(2): 230 - 234.
  • 8Ulbright TM. Germ cell tumors of the gonads : a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues [ J ]. Mod Pathol,2005,18 ( Suppl 2) : 61 - 79.
  • 9Mayordomo JI, Paz-Ares L, Rivera F, et al. Ovarian and extragonadal malignant germ-cell tumors in females: a single-institution experience with 43 patients [ J ]. Ann Oncol, 1994,5 ( 3 ) :225 - 231.
  • 10Umezu T, Kajiyama H, Terauchi M, et al. Long-term outcome and prognostic factors for yolk sac tumor of the ovary [J]. 2008,70(1-2):29 -34.

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  • 1中华医学会病理学分会儿科病理学组,中国抗癌协会小儿肿瘤专业委员会病理学组,福棠儿童医学发展中心病理专业委员会,国家卫健委儿童血液病、恶性肿瘤专委会病理学组,徐曼,何乐健.中国儿童颅外卵黄囊瘤病理诊断规范化专家共识[J].临床与实验病理学杂志,2024,40(7):680-684.

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