青少年卵巢肿瘤的临床病理分析

目的:探讨青少年卵巢肿瘤的临床病理特点。方法:回顾性分析67例20岁以下的青少年卵巢肿瘤患者的临床表现、诊断、病理和治疗。结果:临床症状以腹痛、腹部包块为主,肿瘤扭转率高。良性肿瘤41例,交界性3例,恶性23例;组织学类型以生殖细胞肿瘤最多。恶性肿瘤中65.2%为FIGOI期。除8例恶性患者进行了肿瘤细胞减灭术外,其余59例均进行了保留生育功能的手术。15例恶性肿瘤患者术后化疗。单因素分析显示仅化疗方案影响生存期,BEP优于VAC。结论:青少年卵巢肿瘤的临床病理特点与成人不同,首选保留生育功能的手术,BEP是恶性患者的一线化疗方案。

Clinical and Pathological Features of Ovarian Tumors in Adolescent

Objective: To study the clinical and pathological features of ovarian tumors in adolescent. Methods: The clinical manifestations, diagnostic procedures, pathological characteristic and treatment of 67 cases less than twenty years were analyzed retrospectively. Results: Abdominal pain and mass were the most common symptoms. The frequency of complications such as torsion (23.9%, n=16) and rupture (1.5%, n=1) in these adolescent were significantly higher than adults. Ultrasound was the first choice for diagnosis with higher accurate rate (94.4%). Serum AFP, HCG, CA_(125), and E_2 detection was useful to diagnose malignant germ cell tumors, epithelial tumors and sex cord-stromal tumors, respectively. Among these the 67 cases, 41 were benign, 3 were borderline and 23 were malignant tumor. Germ cell tumor was the most frequent histological type, which account for 65.7%(44/67). 65.2% (15/23) of malignant cases were FIGO stage I. 59 patients received conservative surgery, except 8 malignant germ cell tumor cases received cytoreductive surgery. Adjuvant chemotherapy was taken in 15 patients with stage Ic or higher, VAC (Vincristine + Actinomycin D + Cyclophosphamide) was used before 1990 and BEP (Belomycin + Etoposide+Cis-platinum) after 1991.The mean course was 4.4. Only chemotherapy regiments was correlated with survival, BEP protocol was superior to VAC. Conclusions: Germ cell ovarian tumors is the most common type in adolescent. The clinical and pathological features are different with adults. Conservative surgery should be the standard approach for malignant germ cell tumor patients regardless of tumor stage. BEP is the first line regimen for chemotherapy.