卵巢交界性肿瘤的临床特征及治疗

目的明确卵巢交界性肿瘤（交界性瘤）的临床特征及治疗方法。方法对３５年来收治的７０例卵巢交界性瘤患者进行回顾性分析。结果患者年龄１６～７６岁,平均４５．６岁。组织类型粘液性４６例（６５．７％）,浆液性２１例（３０％）;临床分期Ⅰ期４６例（６５．７％）,Ⅱ期１例（１．４％）,Ⅲ期１１例（１５．７％）,无Ⅳ期患者。治疗后复发１２例（１７．１％）。ＣＡ１２５升高１１例（１１／２１）,癌胚抗原（ＣＥＡ）升高６例（６／１０）。治疗以手术为主,４５例术后接受辅助治疗。７０例中无瘤存活４５例,带瘤存活４例,死于交界性瘤１１例,死于其他原因１０例。１１例行单侧附件切除的Ⅰ期患者均无瘤存活。１６例术后有肿瘤残留并接受辅助治疗者中完全缓解２例。全组５年、１０年、２０年、３０年存活率分别为９０．０％、８７．１％、８７．１％和８５．６％。多因素分析显示,组织学类型、期别和术后肿瘤残留,是影响预后的主要因素。结论粘液性瘤所占比例明显高于浆液性瘤;手术治疗是交界性瘤有效的治疗手段,应力求将肿瘤完全切除;术后辅助治疗不能改善交界性瘤患者的预后;ＣＡ１２５和ＣＥＡ对于交界性瘤监测有一定意义

The clinical features and management of borderline ovarian tumors

OBJECTIVE: To study the clinical features and management of borderline ovarian tumor (BOT). METHODS: Retrospectively study 70 cases of BOT. RESULTS: Age 16-76 years old, average 45.6 year old; histological type: mucinous 46(65.7%), serous 21(30%); stage: I 46 (65.7%), II 1(1.4%), III 11(15.7%), IV 0%, relapse 12(17.1%). Tumor marker: elevated CA125 11/21, carcinoembryonic antigen (CEA) 6/10. Treatment: all patients were operated, 45 were given adjuvant therapy. Outcome: No evidence of disease (NED) 45, with evidence of disease (WED) 4, died of disease (DOD) 11, died of intercurrent disease (DID) 10. 11 patients who were given conservative surgery were NED, there were 2 long term CR among 16 patients with residual disease who were given adjuvant treatment. The 5, 10, 20 and 30-year survival is 90.0%, 87.1%, 87.1% and 85.6% respectively. COX hazard regression model analysis showed that histological type (r = 24.825), stage (r = 2.236) and residual disease (r = 2.083) were the main factors which impact on the prognosis of BOT. CONCLUSIONS: (1) The proportion of mucinous tumor is higher than that of serous tumor in this group; (2) Surgery is the proved only effective treatment of BOT till now, without any residual disease is expected; (3) Adjuvant therapy can't improve the prognosis of BOT; (4) CA125 and CEA can be two effective tumor markers in monitoring of BOT.