疑诊为卵巢癌的妇科盆腔良性疾病的临床特点分析及鉴别诊断

目的 探讨常见的疑诊为卵巢癌的妇科良性疾病的种类、临床特点,并对其良恶性的鉴别诊断作相关讨论.方法 对临床征象与卵巢癌类似但经术后病理诊断为良性病变的131例女性妇科盆腔肿物患者的临床资料、影像学及实验室检查等进行回顾性分析,并对其临床特点进行总结.结果 131例患者中,非肿瘤性病变68例,包括非特异性盆腔炎27例、子宫内膜异位症15例、子宫内膜异位症合并非特异性盆腔炎11例、结核8例、异位妊娠7例;肿瘤性病变63例,包括卵泡膜细胞瘤38例、子宫平滑肌瘤25例.慢性盆腔炎(包括慢性输卵管炎、盆腔包裹性积液、输卵管卵巢脓肿及盆腔脓肿)、卵巢子宫内膜异位囊肿、卵巢子宫内膜异位囊肿合并盆腔炎、盆腹腔结核、输卵管卵巢结核、异位妊娠、卵巢卵泡膜细胞瘤及特殊部位的子宫肌瘤(如向阔韧带及后腹膜发育的子宫体部、颈峡部肌瘤)等极易与卵巢癌相混淆.结论 采用多种手段进行综合评价,可以较准确地掌握妇科盆腔良性疾病的临床特点,作出良恶性的鉴别诊断.

Analysis of clinical characteristics and differential diagnosis of gynecological pelvic benign diseases similar to malignant ovarian tumors

Objective To explore clinical characteristics and types of gynecological pelvic benign diseases similar to malignant ovarian rumors, and to discuss differential diagnosis of benign and malignant gynecological pelvic benign masses. Methods The clinical data, imaging and laboratory examinations of 131 cases, whose clinical symptoms resembled malignant ovarian tumors but pathologically were diagnosed of benign diseases , were reviewed.Results Many kinds of atypical benign diseases were easily confused with malignant ovarian tumors, such as chronic pelvic inflammatory including chronic salpingitis, pelvic encapsulated hydrops, mbo-ovarian abscess, pelvic abscess, ovarian endometriosis, ovarian endometriosis merging with pelvic inflammatory, abdominal and/or pelvic tuberculosis, tubo-ovarian tuberculosis, eccyesis, ovarian thecoma and hysteromyoma of specific site, for example corpus, cervix and isthmus uteri. Conclusions Evaluation by varying measures can effectively get hold of the clinical characteristics of gynecological pelvic benign diseases. It has important value to identify benign and malignant female pelvic masses in complex clinical settings.