年轻非良性卵巢肿瘤患者保留生育功能57例临床分析

目的分析年轻非良性卵巢肿瘤患者保留生育功能治疗的现状及复发情况。方法选择2000年1月至2010年4月北京大学人民医院收治的年龄≤40岁、未完成生育功能、因交界性或恶性卵巢肿瘤行保留生育功能治疗的患者57例,分析临床资料并随访肿瘤的复发情况。结果在57例患者中,交界性卵巢上皮性肿瘤38例（66.7%）,恶性生殖细胞肿瘤17例（29.8%）,其他类型2例;肿瘤分期Ⅰ期49例（86.0%）,Ⅱ期2例,Ⅲ期6例;单侧附件切除手术者33例（57.9%）,行分期手术者17例（29.8%）;化疗29例（50.9%）。成功随访42例,中位随访时间40.5个月（10～119个月）。恶性肿瘤患者无复发;交界性肿瘤患者中,8例复发,复发率25.0%。交界性肿瘤复发组（8例）和非复发组（24例）患者中位无瘤生存时间分别为21.5个月和40.5个月（P〈0.01）。微乳头结构是交界性浆液性卵巢肿瘤患者复发的危险因素（P〈0.05）。结论≤40岁、未完成生育功能的非良性卵巢肿瘤患者中以交界性肿瘤最常见;目前保留生育功能的治疗存在不同程度的问题;但肿瘤本身的特点是影响复发的主要因素。

Investigation of the status and recurrence of young non- benign ovarian tumour patients after fertility preservation therapy

Objective To investigate the status and recurrence of young non-benign ovarian tumour patients after fertility preservation therapy.Methods Patients who were treated with fertility preservation therapy for borderline or malignant ovarian neoplasms in Peking University People＇s Hospital from January 2000 to April 2010 with not elder than 40-year-old and nulliparous were analysed retrospectively and followed up about the recurrence.Results There were 57 patients suitable to the selection criteria.The most frequent type was borderline tumors（38 patients,66.7%）,and the second was malignant ovarian germ cell tumors（17,29.8%）.49 patients（86.0%）had stage I malignant tumors.33 patients（57.9%）were operated with unilateral oophorectomy,and 17 patients（29.8%）with complete staging operation.29 patients（50.9%）received adjuvant chemotherapy.42 patients were followed up successfully for 10～119（median 40.5）months.There was no recurrence in all the malignant patients.8 recurrence（25.0%）were happened in borderline tumors patients,among of which 24 patients had no recurrence.Median disease-free survival time was 21.5 months（recurrence group）,40.5 months（no recurrence group）respectively（P0.05）.Pathological feature with micro-papillary architecture was the prognostic factor for recurrence of serous borderline tumors（P0.05）.Conclusions Borderline tumors are the most frequent type in the non-benign ovarian tumour patients who are younger than 40-year-old.Current fertility preservation therapy has some problems.The characteristics of tumors themselves are the main factors related to recurrence.