儿童卵巢恶性肿瘤21例临床分析  

Analysis of 21 cases of malignant ovarian tumor in children

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：《现代肿瘤医学》2013年第6期1355-1359,共5页Journal of Modern Oncology

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

摘　　要：目的:分析总结儿童卵巢恶性肿瘤的临床特征及诊治经验。方法:回顾性分析2003年6月至2012年6月中国医科大学附属盛京医院诊断及治疗的21例儿童卵巢恶性肿瘤患儿的临床资料。结果:10年中我院共诊断并治疗儿童卵巢原发性恶性肿瘤21例,院内检出率为0.13‰。平均年龄9.9岁(2-14岁)。其中卵巢生殖细胞肿瘤17例(内胚窦瘤10例,无性细胞瘤3例,双卵巢分别为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),性索间质细胞瘤(幼年型颗粒细胞瘤)2例,上皮性肿瘤2例(交界性肿瘤1例,上皮性癌1例)。国际妇产科联盟分期:I期14例(66.7%),Ⅱ期1例(4.8%),Ⅲ期4例(19.0%),Ⅳ期2例(9.5%)。3例行肿瘤细胞减灭术,其余18例行保留生育功能手术。13例术后行系统化疗,其余患儿未行系统化疗。随访患者1-96个月,死亡3例,复发1例,失访3例,余14例均存活至今,无肿瘤复发证据,无生长发育异常。结论:儿童卵巢恶性肿瘤以生殖细胞肿瘤为主,期别偏早,预后较好,重在早期发现及以手术治疗为主、化疗为辅的综合治疗,治疗过程中需充分考虑患儿的生育功能。Objective：To investigate the clinical characteristics,treatment of ovarian malignant tumor in children.Methods：Twenty-one malignant ovarian tumor patients under 14 years old,were diagnosed and treated in Shengjing Hospital affiliated to China Medical University from June 2003 to June 2012.A retrospective analysis was conducted on the clinical data of them.Results：The incidence of ovarian malignant tumor in children was 0.13‰ in the past 12 years in our hospital.Age range was 2 to 14 years（average 9.9 years）.Histologically,ovarian germ cell tumors（n=17） were found most frequently,including yolk sac tumor（n=10）,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.Two were diagnosed as sex cord stromal tumor（both juvenile granulosa cell tumor）,two were diagnosed as ovarian epithelial tumors（one was epithelial borderline,the other epithelial cancer）.There were 14（66.7%） in stage I（FIGO）,Ⅰ（4.8%） in stage Ⅱ（FIGO）,4（19.0%） in stage Ⅲ（FIGO） and 2（9.5%） of them in stage IV（FIGO）.Patients were mostly treated with fertility preservation surgery（n=19） and the rest was cytoreductive surgery（n=3）.Thirteen patients were treated with chemotherapy after operation.During a follow-up of 1-96 months,there were 3 death cases and 3 cases lost.The rest children are healthy.Conclusion： Germ cell tumors are predominant malignant ovarian tumor in children and are mostly in early stage.Early diagnosis is crucial for ovarian cancer diagnosed in children.Completely resection of tumor and chemotherapy as adjuvant therapy is main treatment method.Fertility function should be preserved if possible.

关 键 词：儿童 卵巢恶性肿瘤 诊断 治疗 

分 类 号：R737.31[医药卫生—肿瘤]