卵巢冠囊肿的病理类型及治疗

目的探讨卵巢冠囊肿的发病率、临床表现、病理类型及治疗。方法回顾性分析腹腔镜手术剔除的191例卵巢冠囊肿患者的临床资料。结果191例卵巢冠囊肿患者中有175例(91.62%)为单纯囊肿;15例(7.85%)为上皮性囊肿(其中13例为浆液性囊腺瘤,1例为浆液性乳头状囊腺瘤灶性交界,1例为副中肾管源囊腺瘤、腺体增生并中重度非典型性增生);1例(0.53%)为高分化乳头状间皮瘤。共有6例发生扭转,占3.1%,其中右侧4例,左侧2例。扭转囊肿直径为6~12.67 cm,平均(8.66±2.73)cm,扭转度为360°~720°。育龄妇女为主要发病人群,发病高发年龄为(34.0±11.4)岁。临床多无症状,肿瘤标记物CA125检查均正常,所有患者根据年龄选择相应的手术。结论卵巢冠囊肿并非单纯良性病变,亦有恶变可能,当囊肿直径超过5 cm时可能发生扭转。卵巢冠囊肿恶变绝大部分为浆液性,属低度恶性肿瘤,对恶变的卵巢冠囊肿应根据患者年龄及有无生育要求,采取与早期卵巢肿瘤治疗相同的分期手术方式。

Histopathologic Category and Treatment of Parovarian Cyst

Objective To investigate the incidence,characteristics,histopathologic category and treatment of parovarian cyst.Methods Retrospective analyses of 191 cases who treated with laparoscopic operation for parovarian cyst were analysed retrospectively.Results 1) The incidence of parovarian cyst was 20.9% in all adnexal cysts.175 cases(91.62%) were pure cysts;15 cases(7.85%) were common epithelial ovarian tumors(13 cases were serous cystadenoma;1 case was focal or junctional serous papillary cystadenoma;1 case was cystadenoma genesis from mesonephric duct which was moderate-severe atypical hyperplasia);1 case(0.53%) was high-differentiated papillary mesothelioma.2) 6 cases had the complication of ovarian torsion,4 in right side and 2 in left side.The diameter of torsional cyst ranged from 6¹2.67 cm,the average diameter was((8.66±)2.73)cm.The angle of torsion was 360°～720°.3) The most of cases were in reproductive age and have no obvious clinical manifestation.The levels of CA₁₂₅ in most of cases were normal.Conclusion Parovarian cyst was not an absolute nonmalignant disease and can be developed into malignant disease.The most of malignant parovarian cyst are serosity,which belong to low potential malignancy.The low malignant potential lesions should be treated as ovarian counterparts by laparotomy operation.