卵巢恶性肿瘤患者保留生育功能的再思考

伴随全球晚婚和少育倾向越来越严重，卵巢癌的发病率也逐渐增高。临床工作中经常需要面对恶性卵巢肿瘤患者需要保留生育功能问题。目前Ⅰa期交界性卵巢瘤和Ⅰa期高分化型（G1）除外透明细胞癌的恶性上皮性卵巢癌是保留生育功能手术的适应证。手术以切除患侧附件、对侧卵巢活检、腹水细胞学检测和腹膜后盆腔和（或）腹腔]淋巴结清扫或活检术为基本术式。由于医学伦理学很难对此开展随机对照研究得到结论性数据，造成各个国家或者机构卵巢癌保留生育手术的功能适应证和术式不一致。另一方面随着需要保留生育功能的恶性卵巢肿瘤患者的增加，保留生育功能手术的适应证是否有扩大的可能性值得探讨。

Fertility Preservation for Women with Ovarian Cancer:a Minireview

The fertility preservation for those patients with malignant ovarian tumors are often an important problem for clinical doctors, due to more and more late marriage and fewer births, and increasing rate of ovarian cancer. The indications of preserving fertility include Ⅰa borderline ovarian tumor and Ⅰa of G1 malignant epithelial ovarian cancer except for the clear cell carcinoma. Resection of the affected uterine adnexa, and contralateral ovarian biopsy, ascites cytology and peritoneal lymph nodes （pelvic and/or abdominal） dissection or biopsy are basic surgical technique. It is difficult to carry out the randomized controlled study to get conclusive data due to medical ethics. So, there is inconsistency in indications and surgical methods of preserving fertility for those patients with ovarian cancer. On the other hand, with the increasing patients with malignant ovarian tumors, the indication of preserving fertility might be expanded. This paper reviewed these hot issues.