CA125、CA19．9、CEA在卵巢上皮性交界性肿瘤中的临床价值

目的：探讨测定血清CA125、CA19．9、CEA在诊断卵巢上皮性交界性肿瘤中的临床价值。方法：回顾分析卵巢交界性肿瘤50例血清CA125、CA19．9、CEA水平与临床资料。结果：浆液性及粘液性肿瘤中CA125的阳性率分别为53．85％和60％,差异无显著性（P＞0．05）,临床分期晚者CA125阳性率有增高趋势;粘液性肿瘤中CA19．9的阳性率为43．75％;CEA阳性率为12％,仅见于粘液性或以粘液性为主的肿瘤中;与术前相比,术后CA125、CA19．9水平及阳性率均显著下降（P＜0．05）。结论：CA125、CA19．9对卵巢上皮性交界性肿瘤的术前诊断及疗效监测有一定价值,CEA则在鉴别组织学类型中有一定价值。     

卵巢交界性上皮性肿瘤58例临床分析

目的:探讨卵巢交界性上皮性肿瘤(BOT)的临床情况及影响复发的有关因素.方法:回顾性分析我院诊治的58例BOT患者的临床资料及治疗结局.结果:58例患者的平均发病年龄为37.6岁;临床表现以无症状的盆腔肿块为主,共29例占50.00％;血清肿瘤标志物:CA 125升高33例(56.90％),CA199升高20例(34.48％),两者比较差异有统计学意义(P＜0.05).所有患者均进行手术治疗,其中37例患者行保留生育功能手术.分期以Ⅰ期最多,占87.93％;浆液性和黏液性分别为25例和33例.术后随访8 ～68月,患者均存活;4例(6.90％)复发,肿瘤有微乳头或浸润性种植的患者复发率较高(P＜0.05).5例保留生育功能手术的患者在手术后正常妊娠并分娩.结论:BOT患者较年轻,以Ⅰ期为主,血CA125检测对诊断有帮助.手术是主要治疗手段,患者预后较好.其复发与肿瘤存在微乳头或浸润性种植可能有关.对其进行保留生育功能手术是安全有效的,术后需长期随访.     

卵巢上皮性交界性肿瘤

主要讨论内容:1.卵巢上皮性交界性肿瘤的命名与诊断标准2.卵巢上皮性交界性肿瘤的种植与转移3.卵巢上皮性交界性肿瘤诊断的困难性4.卵巢上皮性交界性肿瘤的分期、预后及复发5.卵巢上皮性交界性肿瘤的治疗探讨6.复发性卵巢上皮性交界性肿瘤的治疗7.卵巢上皮性交界性肿瘤治疗的随     

IL-6、CRP、CA_(125)在卵巢肿瘤定性诊断中的价值及临床意义

目的 :探讨测定血清IL 6、CRP、CA12 5水平在卵巢肿瘤定性诊断中的价值及临床意义。方法 :取卵巢肿瘤 61例患者的血浆及 17例合并腹水患者的腹水 ,用ELISA法及胶乳凝集法测定IL 6、CA12 5、CRP。结果 :IL 6诊断卵巢癌敏感性为 80 .9% ,特异性为77.3%。CA12 5诊断卵巢癌敏感性为 85 .7% ,特异性为 80 .9%。这二项指标联合检测 ,敏感性为 92 .5 % ,特异性 73.9%。CRP诊断卵巢癌敏感性达 76.2 % ,特异性 60 .0 %。临床分期晚、组织分化低者血清及腹水IL 6、CA12 5水平明显升高。结论 :IL 6、CA12 5是卵巢肿瘤定性诊断的良好指标 ,联合检测可提高定性诊断的敏感性及特异性。腹水或血中IL 6、CA12 5水平可为卵巢癌早期诊断、分期及判断预后提供有效的参考指标。     

卵巢交界性上皮性肿瘤临床分析

目的分析卵巢交界性上皮性肿瘤的临床特点、治疗及预后情况,并探讨影响卵巢交界性肿瘤复发及预后的相关因素。方法回顾性分析1980年1月至2009年8月间在北京大学人民医院诊断的卵巢交界性上皮性肿瘤130例,所有患者均经手术治疗及术后病理证实。且经正规肿瘤术后随访12～240个月。结果平均发病年龄为42.3岁;Ⅰ、Ⅱ、Ⅲ期分别为106、6、18例;浆液性、黏液性和其他病理类型各48、63、19例;49.0%(51/104)的患者CA125升高;1%有微乳头浸润,0.05%有浸润性种植;所有患者均进行手术治疗,其中42.3%保留生育功能。复发率为6%(8例),其中18例行卵巢肿物剥除术2例复发,34例单侧或双侧附件切除术未见复发。肿瘤分期手术与一侧附件切除及单纯肿物剥除术的5年及10年存活率分别为100%、100%、95%。结论卵巢交界性肿瘤发病年龄较轻,Ⅰ期为主,黏液性肿瘤多见,预后良好,手术是主要的治疗手段,对早期患者行保留生育功能的手术是安全有效的,术后需长期随访。FIGO分期、微乳头型病变,浸润性种植及初次术后是否残留是影响复发及预后的相关因素。     

卵巢上皮性交界性肿瘤87例临床分析

卵巢上皮性交界性肿瘤是一种具有潜在的或不典型增生能力的卵巢肿瘤 ,主要病理类型为粘液性和浆液性。我们对 87例卵巢上皮性交界性肿瘤的临床资料进行回顾性分析 ,探讨其术前辅助诊断及治疗方法。1　资料与方法1.1　临床资料　 1990年 1月至 2 0 0 2年 6月在上海医科大学妇产科医院和 1995年 1月至 2 0 0 2年 6月在浙江省温岭市第一人民医院收治的经病理证实为卵巢上皮性交界性肿瘤患者 87例 ,13～ 76岁 ,平均 4 3.5岁 ,绝经者 2 1例 (2 4 .14 % )。以盆腔肿块为主要症状者 5 6例 (6 4 .32 % ) ,腹胀 16例(18.18% ) ,阴道出血 9例 (10 .35 …     

卵巢交界性上皮性肿瘤30例临床与病理分析

回顾性分析我院及福建省安海、永春县等医院１９８３年６月－１９９３年６月期间经手术及病理证实的３０例卵巢交界性上皮性肿瘤的临床及病理特点。     

卵巢交界性上皮性肿瘤54例临床及病理分析

目的 :探讨卵巢交界性肿瘤的临床特征和治疗方法。方法 :回顾性分析 5 4例卵巢交界性肿瘤的临床病理学资料。结果 :发病年龄平均 41.2岁 , 期 45例占 83.3% ,粘液性 30例 (5 5 .6 % ) ,浆液性 17例 (31.5 % ) ,混合性 7例(13.0 % )。治疗后仅 1例 (1.9% )复发。治疗以手术为主 ,31例术后辅以化疗。 2 3例 (4 2 .6 % )行保守性手术 ,其中 4例在随访期间正常妊娠及分娩。结论 :卵巢交界性上皮性肿瘤预后良好 ,手术是其有效的治疗手段 ,对临床 期 ,尤其需保留生育功能者 ,保守性手术较安全有效 ,而对 期及以上患者 ,仍主张行根治性手术以减少复发机会     

卵巢交界性上皮性肿瘤的预后分析

目的:探讨卵巢交界性上皮性肿瘤影响预后的因素。方法:回顾分析71例卵巢交界性上皮性肿瘤患者的临床资料,采用单因素和多因素分析方法分析影响复发和预后的因素。结果:BOT患者的5年总生存率97.0%,5年无瘤生存率为94.0%。单因素分析发现,FIGO分期、微浸润、腹膜种植、手术切除类型(肿瘤剥除与附件切除)、肿瘤包膜破裂、双侧卵巢受累与卵巢交界性肿瘤的预后有关(P0.05)。COX多因素模型分析提示,手术切除类型、肿瘤包膜破裂是影响预后的独立因素(P0.05)。结论:BOT发病年龄轻,预后良好,其复发与肿瘤FIGO分期、微浸润、腹膜种植、手术切除类型、包膜破裂等相关。对有高危因素者术后需长期密切随访。     

交界性卵巢上皮肿瘤微小浸润对预后的影响

1929年Taylor首次描述了具有低度恶性趋势的卵巢上皮肿瘤,即组织学特点和生物学行为介于良性和显著恶性之间的一组肿瘤,又称交界性肿瘤。有关基质内微小浸润和腹膜后淋巴结转移的研究较少,为进一步明确预后因素,追踪对126例卵巢交界性肿瘤伴有微浸润的交界性肿瘤患者进行追踪。定义为每个浸润灶直径<3 mm,总面积小于原发肿瘤5％。采用OC125杂交法测量CA125水平,正常高限<34 U/ml。分析了确诊时年龄、是否绝经、种族、肿瘤分期及是否伴有微     

肿瘤相关抗原CA125诊断卵巢上皮性癌的敏感性及对疗效的观察

应用免疫放射分析方法对１４１例经手术后病理证实的卵巢上皮性癌病人（其中浆液性乳头状囊腺癌６９例，子宫内膜样腺癌２４例，粘液性癌１６例，未分化癌２６例，透明细胞癌６例）进行血清ＣＡ＿（１２５）测定。对其中５０例手术前ＣＡ＿（１２５）阳性病人，在术后１～３个月进行两次以上的血清ＣＡ＿（１２５）测定，观察疗效和ＣＡ＿（１２５）水平变化间的相关性，对１例浆液性癌病人术后２个月始，每两周测定一次血清ＣＡ＿（１２５）连续测定１０个月。结果：浆液性癌阳性率为９４％，子宫内膜样腺癌阳性率为７９％，粘液性癌均为阴性，未分化癌阳性率为３８％，透明细胞癌均为阳性。全部病人疗效为完全缓解的２１例，术后ＣＡ＿（１２５）水平较术前明显下降（Ｐ＜０．００１），疗效为进展的２２例，术后ＣＡ＿（１２５）值较术前明显增高（Ｐ＜０．００１），疗效为无改变的７例，手术前、后ＣＡ＿（１２５）值，差异无显著性（Ｐ＞０．０５）。提示：ＣＡ＿（１２５）免疫放射分析对卵巢上皮性癌有较高的敏感性和特异性，对疗效观察有参考价值。     

Comparison of risk of malignancy index (RMI), CA125, CA 19-9, ultrasound score,and menopausal status in borderline ovarian tumor

Objective: The aim of this study was to assess the prognostic values of risk of malignancy index (RMI IV), ultrasound score, menopausal status, and serum CA125 and CA19-9 level in patients with borderline ovarian tumor (BOT). Methods: Fifty women having borderline ovarian tumor (BOT) and 5O individuals with benign adnexal mass were enrolled in this retrospective study. The sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of preoperative serum levels of the CA125 and CA19-9, ultrasound findings and menopausal status, and RMI IV were calculated for prediction of discrimination between BOTs and benign adnexal masses and the results were compared. Results: The RMI IV was the best method for discrimination between BOTs and benign adnexal masses and was more accurate than the other parameters. When Receiver Operator Characteristic area under the curves for menopausal status was analyzed, serum CA 125 and CA19-9 level, ultrasound score, RMI IV(CA125), and RMI IV(CA19-9) were, 0.580, 0.625, 0.548, 0.694, 0.734 and 0.711, respectively. The best RMI IV cut-off was found to be 200 for discrimination of benign and BOT lesions. In the RMI formulation, replacing CA125 with CA19-9 didn’t affect RMI IV sensitivity and specificity for discrimination. Conclusion: Compared to ultrasound, menopausal status, CA-125, CA19-9, the RMI IV was found to be the best predictive method for differentiation of BOTs from benign adnexal masses. RMI IV cut–off value of 200 is suitable for differentiation of benign and BOT’s.     

Recurrence and prognostic factors in borderline ovarian tumors

OBJECTIVE: The purpose of this study was to evaluate the survival estimates and clinico-pathological variables in patients treated for borderline ovarian tumors. METHODS: The patients treated for borderline ovarian tumors were evaluated retrospectively. Data were obtained from hospital records and special gynecologic oncology forms. RESULTS: Overall, 100 patients were evaluated. The mean age at the time of diagnosis was 41.7 (range, 19-84). Seventy one (71%) patients underwent surgical staging including 49 (49%) of them with comprehensive surgical staging, 22 (22%) with fertility-sparing surgery. Only 30 (30%) patients were unstaged. The histopathological diagnosis was serous, mucinous, and the other types of borderline ovarian tumor in 54 (54%), 39 (39%), and 7 (7%) of the patients, respectively. Seventy patients had stage IA (70%), 10 had stage IB (10%), 9 had stage IC (9%), 3 had stage IIIA (3%), and 8 had stage IIIC (8%) disease. The stage of only four patients in which disease confined to ovary was upgraded as stage IIIC following surgical staging procedure. The recurrence rate was found 3% (3). The overall disease-free survival rates of BOT in surgically staged (comprehensive, fertility-sparing surgery) and unstaged patients were 97.92%, 95.00%, and 96.30%, respectively. But, the overall tumor-free survival was significantly found to be decreased in cases of young age (<30 years old), performing fertility-sparing surgery and presence of micropapillary architecture or peritoneal implants. Overall survival rates of BOT in surgically staged (comprehensive, fertility-sparing surgery) and unstaged patients were 97.9%, and 100% and 100%, respectively. CONCLUSION: Low malignant potential ovarian tumors have excellent survival, and the patients can be treated safely by conservative surgery.     

CA19-9、CA125和CP2在卵巢黏液性肿瘤诊断和监测中的价值

目的探讨血清肿瘤标志物CA19-9、CA125及CP2在卵巢黏液性肿瘤诊断和监测中的价值。方法对北京大学人民医院1999年1月至2007年6月间收治的273例卵巢肿瘤患者的临床资料进行回顾性分析,探讨血清肿瘤标志物CA19-9、CA125及CP2在50例卵巢黏液性肿瘤诊断和监测中的价值,并与223例卵巢非黏液性肿瘤进行比较。结果（1）卵巢黏液性肿瘤中,CA19-9的曲线下面积最大（为0．95）,其次是CA125（为0．90）;而卵巢非黏液肿瘤中,CA125和CP2的曲线下面积最大（均为0．90）。（2）卵巢黏液性肿瘤患者联合检测CA19-9和CA125时,其敏感度（93．8％）较单项检测（CA19-9和CA125分别为75．0％和66．7％）明显提高（P〈0．05）,而特异度（分别为86．1％、86．6％和90．2％）无明显变化（P〉0．05）。卵巢非黏液性肿瘤患者联合检测CA125和CP2时的敏感度（85．0％）,较CP2（70．6％）单项检测明显提高,差异有统计学意义（P〈0．05）;较CA125（80．7％）单项检测虽有提高,但差异无统计学意义（P〉0．05）;3者的特异度（分别为90．2％、88．5％和93．9％）比较,差异无统计学意义（P〉0．05）。（3）82例卵巢恶性肿瘤术前血清肿瘤标志物阳性患者中。可行满意的肿瘤细胞减灭术患者[70％（57／82）]的血清肿瘤标志物于术后2个月内降为正常的百分率高于未能行满意肿瘤细胞减灭术者（分别为75％和28％）,差异有统计学意义（P〈0．05）;且其术后血清肿瘤标志物再次上升的平均时间延长（分别为18．2和16．4个月）,但差异无统计学意义（P〉0．05）;复发率（分别为35％和56％）及死亡率（分别为14％和32％）降低,差异有统计学意义（P〈0．05）。20例术前血清肿瘤标志物阴性患者均可行满意的肿瘤细胞减灭术,其中复发患者仅2例（10％）。（4）卵巢黏液性肿瘤患者术后复发时多为血清CA19-9水平上升,而卵巢非黏液性肿瘤术后复发时主要为血清CA125水平上升,部分患者血清CP2水平也上升。（5）术前血清肿瘤标志物阳性患者较阴性患者生存率明显下降,其中CA125（＋）与CA125（-）、CP2（＋）与CP2（-）患者间生存率比较,差异有统计学意义（P〈0．05）;而CA19-9（＋）与CA19-9（-）患者间生存率比较,差异则无统计学意义（P〉0．05）。结论CA19-9是诊断卵巢黏液性肿瘤的敏感指标,与CA125联合检测可提高对卵巢黏液性肿瘤诊断的敏感度,并对术后监测有重要临床意义。CA125和CP2联合检测则对诊断卵巢非黏液肿瘤更敏感。     

Fertility and recurrence results of conservative surgery for borderline ovarian tumors

OBJECTIVES: To evaluate the fertility and recurrence outcomes in women treated with fertility-sparing surgery for borderline ovarian tumors. METHODS: A total of 142 patients with borderline ovarian tumors managed surgically from 1993 to 2004 were identified from gynecologic oncology and pathology files of SSK Ankara Maternity and Women's Health Teaching Hospital. Sixty-two of those patients who had conservative surgery were eligible for the study. Information was acquired by retrospective medical record review and patient interview. RESULTS: The observed recurrence rates after radical and fertility-sparing surgery were 0.0% and 6.5%, respectively. Four patients from the conservative surgery group developed recurrence, in contrast to none of the patients from the non-conservative surgery group. No disease-related deaths occurred in any group. In the conservatively managed group, ten women had successful pregnancies, with a total of 10 live births and 3 abortions. The mean duration of follow-up for the conservative surgery group was 44.3 months (range, 3-128). CONCLUSION: Fertility-sparing surgery for borderline ovarian tumors should be considered for women in the reproductive age group who desire preservation of fertility. Recurrence is noted significantly more often after this type of treatment and close follow-up is needed to detect recurrent disease.     

Ovulation induction treatment and risk of borderline ovarian tumors

Aim. Research has suggested an association between the use of ovulation induction drugs and the risk of ovarian cancer. It has also been proposed that there may be pre-cancerous alterations in the ovary which themselves are the cause of infertility. The aim of the present study was to evaluate the relationship between the use of ovulation induction drugs and the appearance of borderline ovarian tumors.

Material and methods. This was a case–control study in which the study group comprised 42 women with a borderline ovarian tumor and the control group comprised 257 women with benign ovarian pathology.

Results. No differences were found between the borderline tumor and control groups (14.3% vs. 27.2%, respectively) in terms of infertility history. Nor were there any differences between the groups with respect to the type of drug used, whether clomiphene citrate (9.5% vs. 6.2%, respectively) or gonadotropins (7.1% vs. 10.1%, respectively). Analysis in terms of the number of cycles administered also failed to reveal any differences. The mean number of cycles with clomiphene citrate/gonadotropins was 2.50 ± 1.00 and 3.00 ± 2.64 in the borderline tumor group and 2.44 ± 1.75 and 3.27 ± 2.25 in the control group.

Conclusions. Our series produced no evidence that ovulation induction treatment predisposes women to the development of borderline ovarian tumors.