儿童卵巢恶性生殖细胞肿瘤17例临床分析  

The diagnosis and treatment of malignant ovarian germ cell tumor in children:a clinical study of 17 patients

作　　者：张丹晔[1] 谭明子[1] 王慧敏[1] 李潇[1] 高一平[1] 郭瑞江[1] 林蓓[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国实用妇科与产科杂志》2013年第5期371-374,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：盛京自由研究者计划(200807);辽宁省教育厅重点实验室(2008S247)

摘　　要：目的探讨儿童卵巢恶性生殖细胞肿瘤的临床特征及诊断和治疗方法。方法回顾性分析中国医科大学附属盛京医院2003年6月至2012年6月收治的17例14岁以下(包括14岁)卵巢恶性生殖细胞肿瘤患儿的临床资料。结果 17例患儿均经手术病理确诊,其中内胚窦瘤10例,无性细胞瘤3例,双卵巢分别内胚窦瘤及无性细胞瘤1例,胚胎癌1例,未成熟畸胎瘤2例。14例(Ⅰa期5例,Ⅰc期6例,Ⅱb期1例,Ⅲc期1例,Ⅳ期1例)行保留生育功能的手术,3例行肿瘤细胞减灭术(Ⅰa期1例,Ⅳ期1例,Ⅲc期1例)。11例术后行系统化疗,1例行放疗,3例未行后续治疗,2例不详。随访8～96个月,死亡2例,失访2例,复发1例(二次手术行肿瘤细胞减灭术),余12例患儿均存活至今,无肿瘤复发证据,无生长发育异常。结论儿童卵巢恶性生殖细胞肿瘤在保证手术彻底的前提下,应尽量保留正常的卵巢组织,进而保留生育功能,对于早期肿瘤,可适当缩小手术范围,减少副损伤。Objective To investigate the clinical characteristics, treatment experience of malignant ovarian germ cell tumor in children. Methods Seventeen malignant ovarian germ cell tumor （MOGCT） patients under 14 years old, who were diagnosed and treated in Shengjing Hospital Affiliated to China Medical University between June 2003 and June 2012. A retrospective analysis was conducted on the clinical data of them. Results The seventeen children were all got the final diagnosis by operation, histologically, ovarian yolk sac tumors （ n = 10） were found most frequently,followed by dysgerminoma （ n = 3）, immature ovarian teratomas （ n = 2）, embryonal carcinoma （n = 1 ） and a special case that yolk sac tumor in one ovary and dysgerminoma in the other. Patients were mostly treated with fertility preservation surgery （ n = 14） , including 5 in stage Ⅰ a （ FIGO）, 6 in stage Ⅰ c （ FIGO）, 1 in stage Ⅱ （ FIGO）, 1 in stage Ⅱ （FIGO） and 1 in stage Ⅳ （F1GO）. Three children were treated by cytoreductive surgery, including one in stage Ⅰ , one in stage m c and the other in stage Ⅳ. Eleven patients received chemotherapy and one received radiotherapy after operation. During a follow-up of 8 -96 months, there are 2 death cases, 2 lost cases and one case experienced recurrence. The rest children are healthy. Conclusion The operation method of malignant ovarian germ cell tumor in children should take more consideration in fertility preservation. The lesser degrees of surgical staging would be recommended, especially in early stage.

关 键 词：儿童 卵巢恶性生殖细胞肿瘤 

分 类 号：R711.7[医药卫生—妇产科学]