原发性输卵管癌22例诊断分析  

A analysis of 22 cases of primary fallopian tube carcinoma

作　　者：黄建琴[1] 王莉[1] 朱芝玲[1] 

机构地区：[1]复旦大学附属妇产科医院中西医结合科,上海200090

出　　处：《中国癌症杂志》2011年第8期640-643,共4页China Oncology

摘　　要：背景与目的:原发性输卵管癌是少见的妇科恶性生殖道肿瘤,且该病症状极不典型,是最难确诊的恶性肿瘤之一。本文探讨了原发性输卵管癌的临床表现和诊断方法,分析术前未诊断原因,总结经验,以助于提高临床诊断率。方法:回顾性分析复旦大学附属妇产科医院2009年1月1日—2010年12月31日术前未诊断的22例原发性输卵管癌患者的临床表现、肿瘤标志物、以B超为主的影像学检查等。结果:22例患者中4例有阴道排液,8例有阴道流血,6例有腹痛,12例有腹水,5例感腹胀,3例感纳差恶心,3例感腰酸,2例有体质量下降,1例伴有性交痛,1例有腹泻。B超提示盆腔包块20例,盆腔包块伴发腹水12例。输卵管癌三联征(阴道排液、腹痛和附件包块)仅1例,输卵管癌二联征(附件包块合并阴道排液)2例。18例患者行血清CA125检测,升高者14例,1例术前铁蛋白检测异常升高。结论:原发性输卵管癌临床表现多不典型,不易早期诊断。通过分析本组患者的临床资料,认为综合患者病史、临床表现,并结合B超、CA125和铁蛋白检查,有阴道排液者应尽可能行细胞学检查,必要时行腹腔镜检查,有助于提高对原发性输卵管癌的诊断率。Background and purpose： Primary fallopian tube carcinoma （PFTC） is a rare malignant gynecologic reproductive tract tumors, and with no typical symptoms. It is one of the most difficult diagnosis of malignant tumors. This article discussed the clinical presentation and diagnostic experiences of PFTC. Methods： 22 patients of PFTC without preoperative diagnosis from Jan. 1 2009 to Dec. 31 2010 treated in Obstetrics and Gynecology Hospital of Fudan University were retrospectively analyzed. Results： The clinical manifestations of 22 PFTC were as followed： vaginal discharge （4 cases）, vaginal bleeding （8 cases）, abdominal pain （6 cases）, ascites （12 cases）, abdominal distension （5 cases）, anorexia and nausea （3 cases）, backache （3 cases）, weight loss （2 cases）, painful sexual intercourse （1 case）, diarrhea （1 case）, pelvic mass （20 cases）, ascites associated with pelvic mass （12 cases）, Triad of PFTC consisting of vaginal discharge, abdominal pain and pelvic mass （1 case）, the second joint symptoms consisting of adnexal mass and vaginal discharge （2 cases）. 14 patients had elevated pre-treatment serum CA125 levels among 18 patients and 1 patient had a preoperative detection of abnormal increase of ferritin. Conclusion： The clinical manifestations of PFTC is not typical, early diagnosis difficult. By analyzing the clinical data of patients, history, clinical manifestations, combined with ultrasonography, serum CA125 and ferritin checked, vaginal discharge cytology should be taken as far as possible. If necessary, laparoscopy, would be helpful to improve the diagnosis rate of PFTC

关 键 词：原发性输卵管癌 临床表现 B超 CA125 铁蛋白 

分 类 号：R737.32[医药卫生—肿瘤]