卵巢内胚窦瘤临床特点与预后相关因素分析

目的分析卵巢内胚窦瘤的临床病理学特点,以及Bc l-2在卵巢内胚窦瘤中的表达,探讨影响该病预后的相关因素。方法回顾性分析辽宁省肿瘤医院1984年1月至2007年12月收治的76例卵巢内胚窦瘤患者的临床病理学资料,分析Bc l-2在卵巢内胚窦瘤中的表达,了解各临床病理因素对预后的影响。结果Ⅰ、Ⅱ、Ⅲ及Ⅳ期卵巢内胚窦瘤患者的5年生存率分别为91.8%、88.9%、39.5%及25.0%。年龄、组织学类型、术前血清中甲胎蛋白值水平、是否保留生育功能的手术方式、术前肿瘤大小并不影响该病的预后。以铂类为基础的化疗方案,化疗疗程数〉3,残余瘤直径≤2 cm和腹水量≤100 mL是影响预后的因素。Bc l-2在不同病理类型间表达差异有统计学意义（P〈0.05）,但Bc l-2并不是影响预后的独立因素。结论临床分期,以铂类为基础的化疗方案,化疗疗程数,残余瘤直径和腹水量是影响预后的因素。

Clinical characteristics and prognostic factors of ovarian endodermal sinus tumor

Objective To investigate the expression of Bcl-2 and prognostic factors of ovarian yolk sac tumors（YST）.Methods Seventy-six patients with ovarian YST from Department of Obstetrics and Gynecology,Liaoning Cancer Hospital Institute between 1984 and 2007 were retrospectively reviewed.The expression of Bcl-2 was investigated by immunochemistry.Results The 5-year overall survival rates in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 91.8%,88.9%,39.5%,and 25.0%,respectively.Age,histologic type,preoperative serum α-fetoprotein（AFP） level,fertility-sparing surgery and tumor size did not affect the prognosis of YST.Cisplatin-based chemotherapy,chemotherapy courses3,residual tumor ≤2 cm and ascites volume ≤100 mL were the predictors for overall survival.Bcl-2 was not the predicton affecting the prognosis of YST.Conclusion Cisplatin-based chemotherapy,chemotherapy courses,residual tumor size and ascites volume are prognosis factors.