妊娠合并卵巢恶性肿瘤20例临床分析

目的 探讨妊娠合并卵巢恶性肿瘤的临床特征、处理方法 及预后. 方法 回顾性分析2001年7月至2008年12月在我院诊断及治疗的20例妊娠合并卵巢恶性肿瘤患者的临床及病理资料.结果8年中共诊断妊娠合并卵巢恶性肿瘤20例,发病率0.311/1000次分娩,其中孕期超声诊断14例(70.0%).病理类型中上皮性肿瘤共15例(占75.0%).低度恶性肿瘤(上皮交界性肿瘤和支持间质细胞瘤)共14例(70.0%).20例患者中19例(95.0%)国际妇产科联盟分期1期.16例(80.0%)行保守性手术治疗,4例(20.0%)二次行卵巢癌分期手术.化疗6例(30.0%),其中孕期化疗1例.20例中流产5例;出生新生儿15例,除1例重度窒息死亡外,余4例早产儿及10例足月儿均体健,无后遗症及畸形.随访患者6～80个月,除1例术后4个月死亡,余未见肿瘤复发,生存率95.0%(19/20). 结论 妊娠期妇女的卵巢癌发病率较非妊娠期低,且多为早期,经积极手术及化疗母婴预后大多较好.

Analysis of 20 pregnant women complicated with malignant ovarian tumor

Objective To investigate the clinical characteristics, management and prognosis of ovarian malignant tumor in pregnancy. Methods A retrospective analysis was conducted on the clinical data of 20 women with ovarian malignancies during pregnancy between July 2001 and December 2008. Results The incidence of ovarian malignant tumor in pregnancy was 0. 311/1000 deliveries in the past 8 years and 14 (70.0%) were diagnosed through ultrasound during the index pregnancy. Most of the pathological results were ovarian epithelial tumors (n= 15,75. 0%). Fourteen (70. 0%) were diagnosed as low grade malignant tumors (including epithelial borderline tumor and sertoli-leydig cell tumor). Nineteen (95. 0%) of the patients were diagnosed in stage I (FIGO). Sixteen (80. 0%) were treated by conservative operation, and second ovarian carcinomectomy were performed for four (20. 0%) women. Chemotherapy was administered to 30. 0% (6 cases) of the patients, one of which during pregnancy. Totally, 15 neonates were born. One premature newborn died from severe asphyxia, and the rest 4 preterm and 10 full term babies are healthy. The tumor free survival rate of these 20 women was 95.0% (19 cases) during a follow-up of 6-80 months. Conclusions Ovarian carcinoma has a lower incidence during pregnancy and mostly are in early stage. Proper treatment may ensure a better maternal and fetal outcomes.