卵巢未成熟畸胎瘤的诊治进展

卵巢未成熟畸胎瘤是一种好发于育龄妇女的卵巢生殖细胞肿瘤,极易复发及转移,但复发后再次手术可发生恶性程度逆转现象。其来源被认为与减数分裂错误以及表观遗传失调等有关。卵巢未成熟畸胎瘤的症状和体征缺乏特异性。除了传统检查检验手段外,神经元特异性烯醇化酶检验、¹⁸F-氟脱氧葡萄糖（¹⁸F-fluorodeoxyglucose,¹⁸F-FDG）PET/CT等检查方法被认可。由于其在临床相对少见,因此对于成人及儿童患卵巢未成熟畸胎瘤的最佳治疗方案和管理指南目前尚未达成共识,目前主流的治疗方法以手术为主,非必要不进行化疗,并尽量保留患者的生育能力。由于其较易复发,故术后随访极为重要,频率应与其他恶性肿瘤相同。生长性畸胎瘤综合征是卵巢未成熟畸胎瘤的并发症,在临床上较为罕见,手术是其主要治疗手段,同时对其靶向药物治疗的研究也有所进展。综述近年来卵巢未成熟畸胎瘤的来源、诊断、治疗及其并发症的研究进展,以期为临床诊治提供参考。

Progress on Diagnosis and Treatment of Ovarian Immature Teratoma

Immature teratoma of the ovary is a germ cell tumor of the ovary, which is most frequent in women of childbearing age. It is very easy to relapse and metastasize, but the malignant degree can be reversed after recurrence by reoperation. Its origin is thought to be related to meiotic errors and epigenetic disorders. The symptoms and signs of immature teratoma of the ovary are lack of specificity. In addition to the traditional examination methods, neuronspecific enolase test, ¹⁸F-FDG PET/CT and other examination methods have been approved. It is a relatively rare disease, so there is not a clinical guideline for the treatment of ovarian immature teratoma and follow-up management in those adult and child patients. The current mainstream treatment is surgery, not chemotherapy unless it has to be, and to protect the fertility as far as possible. Due to its relatively easy relapse, postoperative follow up is very important. The follow up frequency should be the same as other malignant tumors. Growing teratoma syndrome is a relatively few complication of ovarian immature teratoma. Surgery is the main treatment method for it, and targeted drug therapy also has some progress. The research progress of the source, diagnosis, treatment and complications of ovarian immature teratoma in recent years was reviewed in order to provide a reference for clinical diagnosis and treatment.