卵巢上皮性交界性肿瘤72例临床病理特征与预后的关系  

Correlation between clinicopathologic characteristics and prognosis of epithelial ovarian borderline tumors:analysis of 72 patients

作　　者：魏鹏[1] 李淑敏[1] 章文华[1] 李洪君[1] 宋艳[1] 张蓉[1] 贾英华[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院妇瘤科

出　　处：《中华临床医师杂志（电子版）》2011年第7期1891-1895,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨卵巢上皮性交界性肿瘤的临床病理特征对预后的影响。方法回顾性分析我院1995年1月至2005年12月初治的72例卵巢上皮性交界性肿瘤的临床病理资料,采用Kap-lan-Meier进行生存分析,并进行复发相关因素分析。结果本组患者的5年无复发生存率为94.4%。4例患者复发,均为黏液性交界瘤,其复发率为5.6%,平均复发时间24个月。单因素分析显示:肿瘤晚期(Ⅲ期与Ⅰ期:25.0%vs.3.1%;P=0.058)、肿瘤破裂(破裂与无破裂:25.0%vs.3.1%;P=0.058)和术后有残存肿瘤(有残存与无残存肿瘤:50.0%vs.1.4%;P=0.055)者的复发率明显高于肿瘤早期、无破裂和手术切净者,但经统计学处理P值处于临界状态。而肿瘤有浸润性腹膜种植(有腹膜种植与无:25.0%vs.4.4%;P=0.208)、双侧卵巢病变(双侧与单侧病变:40.0%vs.3.0%;P=0.22)和术前血清CA199异常升高(异常升高与正常:13.6%vs.4.2%;P=0.64)者的复发率明显高于无浸润性腹膜种植、单侧病变和CA199正常者,但均无统计学意义。另外,患者的年龄(P=0.614)、肿瘤大小(P=1)、有无微浸润(P=0.566)、手术方式(P=0.64)及术后辅助化疗(P=1)等均不影响肿瘤的复发。结论卵巢上皮性交界性肿瘤的预后好,复发率低,且黏液性患者易复发。肿瘤晚期、破裂和术后肿瘤残存可能与交界性肿瘤术后复发相关,而浸润性腹膜种植、双侧卵巢肿瘤、手术方式、年龄、肿瘤大小、微浸润等对交界性肿瘤的复发均无显著影响,且术后辅助化疗也不降低肿瘤复发。Objective To explore the clinicopathologic characteristics and prognosis factors that may be used to predict the prognosis and recurrence of patients with borderline ovarian tumors.Methods All cases with borderline ovarian tumors treated originally in the Cancer Hospital from January 1995 to December 2005 were analyzed retrospectively for clinicopathologic features,treatment parameters and outcome of treatment.Univariate analyses were used to assess independent prognostic factors using the logistic regression model.Results The histologic-type of recurrence are all mucious tumors.The overall disease-free survial of 5-year are both 94.4%,and the recurrence rate is 5.6%.The median time of recurrence was 24 months.The univarite analysis showed that advanced stage(stageⅢ vs. stageⅠ:25.0% vs.3.1%,P=0.058),rupture of cyst(yes vs.no:25.0% vs.3.1%,P=0.058) and residual tumor(yes vs.no:50.0% vs.1.4%,P=0.055) have a significantly higher relapse rate,but the P value are at the critical state.Peritoneal implants(yes vs.no:25.0% vs.4.4%,P=0.208),bilateral tumors(bilateral vs.uniletral:40.0% vs.3.0%,P=0.22)and the level CA199 from preoperational serum(abnormal vs.normal:13.6% vs.4.2%,P=0.64)have to been shown affecting recurrence clearly,but without statistics significance.The age(P= 0.614), tumor size(P=1),stromal microinvasion(P=0.566),the way of surgery(P=0.64),postoperative adjuvant theraphy(P=1) have none value in predicting risk for recurrence.Conclusions Patients with borderline ovarian tumors have an excellent prognosis and low relapse rate,and mucious borderline tumors tend to be a higher relapse rate.Advanced stage rupture of cyst and residual tumor may be significant factors that influnced recurrence.However,peritoneal implants,bilateral tumors,the way of surgery,age, tumor size,stromal microinvasion were not significantly correlated with recurrence.Even postoperative adjuvant theraphy do not show a better result.

关 键 词：卵巢肿瘤 交界性 病理学 临床 预后 

分 类 号：R737.31[医药卫生—肿瘤]