30岁以下卵巢肿瘤患者223例临床分析  

Analysis of 223 Case of Ovarian Neoplasms in Young Women Aged Under 30 Years Old

作　　者：张晓勇[1] 米淑玲[1] 尹利荣[1] 郭素杰[1] 时扬[1] 

机构地区：[1]天津医科大学第二医院妇科,300211

出　　处：《国际妇产科学杂志》2009年第2期158-160,共3页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨年龄30岁以下卵巢肿瘤患者的临床特点、病理类型、治疗及预后。方法:回顾性分析1992年10月—2007年10月间、年龄30岁以下223例卵巢肿瘤患者的临床资料。结果:有明显临床症状就诊者占71.30%(168/223)。良性肿瘤192例(86.10%),恶性肿瘤包括低度恶性潜能上皮性肿瘤(LMP)31例(13.90%)。生殖细胞肿瘤91例、上皮性肿瘤72例、性索间质肿瘤9例、卵巢瘤样病变51例。良性肿瘤中蒂扭转者切除卵巢的比例高于非蒂扭转者。恶性肿瘤手术病理分期:Ⅰ期28例、Ⅱ期1例、Ⅲ期2例,其中22例保留生育功能。11例LMP患者术后未化疗,其余20例恶性肿瘤患者中19例进行化疗。随访时间10～181个月,27例无瘤生存,4例死亡;21例月经正常,9例有生育计划的患者中,7次妊娠,4次足月分娩。总5年生存率为80.21%,病理分期是影响生存率的主要因素。结论:30岁以下年轻患者卵巢肿瘤以良性、生殖细胞肿瘤为主。卵巢恶性肿瘤临床手术病理分期早期,手术应尽可能保留生育功能。化疗对卵巢及生育功能无明显影响。应重视年轻女性的临床表现并定期妇科检查。Objective ：To study the characteristic on clinical features, histological type, stage, treatment and outcome of ovarian neoplasm in young women under 30 years old. Methods： A total of 223 cases of ovarian neoplasm in young women less than 30 years old between Oct 1992 and Oct 2007 were analyzed retrospectively. Results：71.30% （168 of all 223 cases） had obvious clinical symptoms. 192 cases （86.10%） were benign tumors and 31 cases （13.90%） were malignant tumors. 91 cases were ovarian germ cell tumor, 72 cases were epithelial ovarian tumor, 9 cases were ovarian gonadal sex cord stromal tumor, and 51 cases were tumor-like disease. The incidence of ovariectomy in the group of ovarian torsion was higher than that of the group without torsion. In the malignant group, 28 cases were stage Ⅰ ,1 cases was stage Ⅱ, and 2 cases were stage Ⅲ. Of all the cases, 22 patients were treated with conservative surgery, 11 patients of LMP without chemotherapy, and 19 patients of malignant tumors without chemotherapy. During the follow-up period ranged from 10 to 181 months, 27 patients were alive and free of tumor and 4 patients died. 21 patients had normal menstruation. Nine patients desired to childbearing had 7 times of pregnancy and 4 times of successful delivery.5-year survival rate was 80.21% respectively. Stage was the most important factor on survival. Conclusion： Benign tumor is the most common ovarian tumor in young women under 30 years old is and germ cell tumor is the most common subtype. Young patients with malignant tumors appear to have favorable stage. Conservative surgery which saves the patient＇s fertility was preferred treatment strategy in young patients with malignant tumors. Standardized chemotherapy has no effect on fertility function. More attention should be paid on the symptoms and check-up regularly are highly recommended for these patients.

关 键 词：卵巢肿瘤 青春期 卵巢切除术 生育力 

分 类 号：R737.31[医药卫生—肿瘤]