54例卵巢交界性肿瘤的临床病理分析  

The clinical pathological analysis of 54 cases with borderline ovarian tumor

作　　者：梅立[1] 岳军[1] 谢兰[1] 

机构地区：[1]四川省医学科学院.四川省人民医院妇产科,四川成都610072

出　　处：《西部医学》2012年第5期858-860,863,共4页Medical Journal of West China

摘　　要：目的探讨卵巢交界性肿瘤(Borderline ovarian tumors,BOT)的临床特点及治疗方法。方法回顾分析6年间收治的BOT患者共54例。依据组织学诊断结果分为单纯BOT(31例)和BOT伴微浸(23例)两组,采用免疫组织化学LDP法检测BOT组织中血管内皮生长因子(VEGF)的表达,探讨其临床病理关系及预后。结果 54例患者中初次手术行保留生育功能手术(卵巢肿瘤剥除术或单侧附件切除术)9例,保留卵巢功能手术6例,卵巢肿瘤细胞减灭术41例;Ⅰ期17例,Ⅱ期28例,Ⅲ期9例,无Ⅳ期病例。交界性肿瘤中浆液性囊腺瘤32例(59.3%),粘液性囊腺瘤18例(33.3%),其他组织类型4例(7.4%)。单纯BOT组中VEGF阳性表达为25.8%(9/31),BOT伴未浸润组VEGF的阳性表达为73.9%(16/23),组间差异有统计学意义(P<0.05)。43例病例随访5～78个月,死亡1例,复发6例;复发病例中浆液性4例,2例为粘液性,1例同时有微乳头结构及微浸润;保留生育功能者3例复发,保留卵巢功能者2例复发,行满意肿瘤细胞减灭术1例复发。结论①血管内皮生长因子(VEGF)可能通过肿瘤血管形成来影响卵巢交界性肿瘤的侵袭和转移。②手术是卵巢交界性肿瘤的主要治疗方法,早期有生育要求的患者可选择保守性手术,并尽量选择附件切除术;晚期患者宜行根治性手术,术后辅助化疗仍是必要的。Objective To study the clinical pathological features and management of Borderline ovarian tumors（BOT）.Methods 54 cases with Borderline ovarian tumors were retrospectively analyzed.54 cases were divided into two groups： simple BOT type and microinvasion type.Their VEGF expressions were analyzed by immunohistochemical methods.Results Surgical treatment included comprehensive staging surgery（n=41）,ovarian cystectomy and unilateral salpingo-ovarectomy（n=9）,ovarian cystectomy and hysterectomy（n=9）;The expression of VEGF in mircinvasion BOT type were higher than those of simple BOT type（P〈0.05）.The average follow-up period was 5-78 months.Relapse occurred in 6 patients,only one patient died of BOT.Four cases of recurrence were serious tumor,among that 1 case had micropapillary pattern associated with microinvasion.There were 3 recurrences among 6 patients treated by ovarian cystectomy and unilateral salpingo-oovarectomy,and 1 recurrence among 6 patients treated by comprehensive staging surgery.Conclusion VEGF maybe play an important role in the angiogenic progression of BOT;Surgery is the key treatment method for BOT.Conservative surgery has comparatively good prognosis and should be the first choice for younger patients with the desire of fertility.Radical surgery should be performed for advanced patients.

关 键 词：卵巢交界性肿瘤 血管内生长因子(VEGF) 手术治疗 预后 

分 类 号：R737.31[医药卫生—肿瘤]