复发性卵巢上皮性癌的诊断及处理

Diagnosis and treatment of recurrent epithelial ovarian carcinoma

目的 探讨复发性卵巢上皮性癌的诊断、治疗方法及其预后。方法 将 5 2例复发性卵巢上皮性癌患者分为 5组 ,手术 +化学药物治疗 (化疗 )组 ,共 2 6例 ;单纯化疗组 ,共 14例 ;手术 +化疗 +放射治疗 (放疗 )组 ,共 4例 ;手术 +放疗组 ,共 4例 ;未治组 :4例。对复发性卵巢上皮性癌的诊断方法和各组间生存时间进行比较。结果 复发性卵巢上皮性癌的诊断方法其阳性诊断率依次为 ,妇科检查 (妇检 ) 73 1% ,B超 84 6 % ,CA12 55 3 8% ,妇检、B超和CA12 5联合检测阳性率为 70 5 %。手术 +化疗组、单纯化疗组的中位数生存时间分别为 11个月和 12个月。手术 +化疗 +放疗组的生存时间为 10～ 12个月。手术 +放疗组的生存时间为 14～ 2 5个月。结论 妇检、B超和CA12 5的联合检测有助于提高复发性卵巢上皮性癌的诊断阳性率。在复发性卵巢上皮性癌治疗中 ,手术的作用有待进一步研究证实 ,化疗具有很好的作用 ,放疗的作用和地位应引起注意。

Objective To investigate the diagnosis,treatment and prognosis of recurrent epithelial ovarian carcinoma. Methods Fifty-two patients with recurrent epithelial ovarian carcinoma who were admitted in Zhongnan Hospital of Wuhan University between 1997 and 2002 were analyzed retrospectively,and their diagnostic methods and the survival rates were compared. Results The positive diagnostic rate of pelvic examination,CA 125 and ultrasound examination was 73.1%,84.6% and 53.8%,respectively to the recurrent epithelial ovarian carcinoma. The median survival time of group A(surgery+chemotherapy) and group B ( chemotherapy) was 11 and 12 months,respectively. Conclusions The diagnostic methods should include pelvic examination,CA 125 and ultrasound examination. We could not know the exact role of surgery to the management and prognosis of recurrent epithelial ovarian carcinoma. Chemotherapy may have an important role to the management and prognosis of recurrent epithelial ovarian carcinoma.