卵巢未成熟畸胎瘤的治疗与预后因素的分析

目的：分析卵巢未成熟畸胎瘤的临床特征、组织成分及生物学行为，找出最佳治疗方案。方法：我院1980年1月——1999年10月住院诊治卵巢未成熟畸胎瘤53例，用生命表法计算生存率及平均缓解时间，并对瘤内组织成分、成熟畸胎瘤恶变、复发瘤良性变及化疗对预后的影响进行回顾性分析。结果：术后7天内化疗者，平均缓解时间最长（P＜0.05)；含有神经上皮成分的未成熟畸胎瘤预后较好（P＜0.05)；成熟畸胎瘤恶变中位发病年龄较未成熟畸胎瘤晚10年且预后差（P＜0.05)；复发瘤良性变的发生有助于患者获得长期缓解（P＜0.05)。结论：卵巢未成熟畸胎瘤术后即时（7天内）化疗是影响疗效的重要因素，瘤内含有神经上皮成分预后较好；成熟畸胎瘤具恶性变、未成熟畸胎瘤的复发瘤具有良性变的特性。因此对于卵巢未成熟畸胎瘤非常强调术后即时化疗，并应采取一切积极措施，保证患者生存，争取良性变的到来。

Analysis of factor influencing prognosis for immature teratoma of ovary

Purpose:To analyse the clinical characteristic, the histological elements and the biological behavior of ovarian immature teratomas in order to find the best treatment. Methods:A total of 53 cases of immature teratomas of ovary entered this study from Jan. 1980 to Oct. 1999. The survival rate and the average remission time were calculated by life table. The histological elements, the teratomas with malignant transformation, the immature teratomas with benign treansformation and the effect of chemotherapy were analysed retrospectively. Results:The average remission time was the longest for patients who received chemotherapy within 7 days after operation ( P <0 05). The prognosis was better in the patients with immature teratomas in which there were neural elements than those without neural elements ( P <0 05). The median age was later by 10 years and the prognosis was poorer in the patients with teratomas with malignant transformation compared to those with immature teratomas ( P <0 05). The occurrence of benign change in recurent tumors led to the patient having long remissions ( P <0 05). Conclusions:The immediate postoperative chemotherapy (within 7 days) is the important factor influencing the prognosis of immature teratomas. The immature teratomas that have neural elements in the tumors have a better prognosis. Mature teratomas have the characteristics of malignant transformation and the recurrent immature teratomas have the those of benign change. So immediate chemotherapy must be emphasized for immature teratomas and everything should be done to maintain life in these patients to wait for the onset of benign transformation.