疑似卵巢癌的盆腔结核20例分析

Analysis of 20 cases of pelvic tuberculosis initially suspected of ovarian carcinoma

目的 分析极易与卵巢癌相混淆的女性盆腔结核的临床特征 ,寻求两者鉴别诊断的依据。方法 对 1994年 3月～ 2 0 0 2年 5月间收治的 2 0例确诊为盆腔结核的患者进行回顾性分析。结果 经济条件差、有结核病史或明确的结核接触史、发热是鉴别晚期卵巢癌与盆腔结核的重要依据。 2 0例中有盆腹腔肿物者 2 0例 ,腹胀 18例 ,腹痛 12例 ,腹水 2 0例 ,发热 18例 ,消瘦 13例 ,腹泻6例。血清CA12 5检测结果最小 6 4U/L ,最高 10 6 9U/L。术前经腹水细胞学检查 16例 ,14例未发现癌细胞 ,1例见可疑癌细胞 ,1例见癌细胞 (手术病理排除 )。结论 女性盆腔结核与晚期卵巢癌鉴别诊断极为困难 ,盆腔肿物、腹水、CA12 5升高的年轻妇女 ,若有结核史或结核接触史、发热 ,且腹水细胞学未发现癌细胞 。

Objective To analyze the clinical characteristics of female pelvic tuberculosis for the differentiation from ovary carcinoma. Methods Twenty patients who were confirmed having pelvic tuberculosis from March 1994 to May 2002 were retrospectively studied. Results Poor economic condition, history of tuberculosis or contact with tuberculosis, and fever were among the most important factors in differentiating pelvic tuberculosis from advanced ovarian cancer. Pelvic mass and ascites were present in all of the 20 patients, abdominal distension in 16, abdominal pain in 12, fever in 16, lost of weight in 13, and diarrhea in 6. The level of serum CA125 ranged from 65 U/L to 1 069 U/L. Peritoneal effusion cytology was studied in 16 cases before operation. Conclusions The clinical differentiation of female pelvic tuberculosis from ovary carcinoma was difficult. Pelvic tuberculosis should be considered in young women presented with pelvic mass, ascites, fever, an elevated CA125 level and negative cytology, and with a history of tuberculosis or contact with tuberculosis