40岁以下妇女卵巢上皮性癌的临床及病理学特点  

The Clinical and Pathological Characteristics of Epithelial Ovarian Carcinoma in Patients with Age under 40

作　　者：温宏武[1] 孙伟杰[1] 郭燕燕[1] 刘书文[1] 

机构地区：[1]北京医科大学第一医院妇产科

出　　处：《中华妇产科杂志》1997年第9期548-551,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：了解年龄小于４０岁妇女卵巢上皮性癌在临床及病理学方面的特点。方法：１９７８年１月至１９９２年１２月在我院诊治的年龄小于４０岁卵巢上皮性癌患者共５４例，选择与每一例同期手术、年龄大于４０岁卵巢上皮性癌５４例作为对照组，用ＳＰＳＳ及ＳＵＲＶＡＬ分析软件对两组临床及病理学资料进行对照分析。结果：年龄小于４０岁患者中，因偶然发现盆腹腔包块就诊者（４６．３％）多于对照组（２７．８％），而因出现症状就诊者（５３．７％）少于对照组（７２．２％），其早期诊断率（６１．１％）、肿瘤单侧发生率（６８．５％）、肿瘤最大径线均值（１３．６ｃｍ）、肿瘤分化程度（高分化占５０．０％）以及达到理想肿瘤细胞减灭术者均高于对照组。两组组织学类型及化疗情况相似。单因素分析，年龄小于４０岁患者预后好，其２年及５年生存率分别为６９．８％和５０．２％，８例保留健侧卵巢者均无复发。多因素分析显示年龄对预后无影响。结论：年龄小于４０岁患者的卵巢上皮性癌其分期较早，恶性程度较低，预后较好，部分患者手术时可保留卵巢功能。Obejctive: To investigate the clinical and pathological characteristics of epithelial ovarian carcinoma in patients with age under 40. Methods: From Jan 1978 to Dec 1992, 54 cases with epithelial ovarian carcinoma under 40 years old were admitted to our hospital and enrolled in the study group, another 54 patients suffered from the same disease with age over 40 in the same period were served as control. Comparison analysis for clinical and pathologic data of 2 groups was performed using SPSS and SURVALC statistics software. Results: Main complaint because of either pelvic mass or abdominal mass found by chance was more common in study group (46.3%) than that in control group (27.8%), whereas because of symptoms was less common in study group (53.7%) than in control group (72.2%). Other parameters such as early stage (Ⅰ and Ⅱ) rate (61.1%), unilateral tumor rate (68.5%), average maximum diameter of tumor (13.6 cm), highly differentiated rate (50%) and the possibility for tumor reductive surgery were higher in study group than in control group. The difference of histological pattern and chemotherapy between 2 groups was not significant. Single variate analysis showed that the prognosis was better in study group. The 2 year and 5 year survival rates were 69.8% and 50.2% respectively. No recurrence was found in the 8 patients in whom the contralateral healthy ovary remained. However multiple variate analysis indicated that age was not a prognostic factor. Conclusion: Epithelial ovarian carcinoma was prone to be lower degree malignancy in patients under 40 years old, therefore the prognosis of them was better. It might be resonable to have healthy ovary left in some selected cases.

关 键 词：卵巢肿瘤 预后 上皮性癌 病理学 

分 类 号：R737.31[医药卫生—肿瘤]