晚期卵巢上皮癌以急腹症为首发症状12例分析  

Clinical analysis of twelve patients with advanced epithelial ovarian cancer presenting initially as abdominal emergency

作　　者：臧荣余[1] 张志毅[1] 翁练斌[1] 蔡树模[1] 

机构地区：[1]上海医科大学肿瘤医院肿瘤妇科,上海200032

出　　处：《中国实用妇科与产科杂志》2001年第3期147-148,共2页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨以急腹症为首发症状的晚期卵巢上皮癌的临床特点与预后。方法　回顾分析 1986年 1月至 1997年 12月我院收治的以急腹症作为首发症状的晚期上皮性卵巢癌 12例。结果　中位年龄 43岁 ( 346 1岁 )。Ⅲa期 1例 ,Ⅲc期 10例 ,Ⅳ期 1例。分化 1级 1例 ,2级 6例 ,3级 5例。术中发现肿瘤破裂 8例 (其中合并肿瘤扭转 2例 ,肿瘤出血 1例 ) ,单纯急腹痛 2例 ,肿瘤性肠梗阻、肠穿孔各 1例。 5例行全子宫、双附件、大网膜切除 ,7例行姑息性肿瘤切除。仅 2例手术后残留灶直径≤ 1cm。 11例术后接受铂类为基础的联合化疗 2 6疗程。生存期 <12月 9例 ,12 2 3月 2例 (包括治疗 14月后失访 1例 ) ,仅 1例存活 2 5月。 5例 ( 41 7% )有肿瘤家族史。结论　晚期上皮性卵巢癌以急腹症为首发症状者有明显的肿瘤家族史 。Objective To investigate clinical characteristics and prognosis of advanced epithelial ovarian cancer presenting as abdominal emergency.Methods 12 patients with advanced epithelial ovarian cancer presenting with abdominal emergency in cancer hospital of SMU from Jan.1986 to Dec.1997 were retrospectively reviewed.Results Median age was 43 years old,ranged from 34~61years.Surgical staging revealed Ⅲa in 1,Ⅲc in 10,Ⅳ in 1.Pathologic examination demonstrated 1 patient was in Grade 1,6 patients were in Grade 2,5 patients were in Grade 3.Tumor rupturing was found during laparotomy in 8 patients,intestine obstruction found in 1 patient,and 2 patients were simply with abdominal pain.Only 2 patients were surgically cytoreduced with residual mass ≤1cm.11 patients received adjuvant chemotherapy postoperation,and paclitaxel were administered for 2 to 6 courses.All patients survived no more than 26 months.9 patients died within 12 months,2 within 12 to 23 months(including 1 case failed to be followed up) and only 1 patient survived 25 months.Five patients(41 7%) had family heredity of cancer. Conclusions Patients with advanced epithelial ovarian cancer presenting initially as abdominal emergency have a distinct tumor family heredity with poor prognosis.

关 键 词：上皮性卵巢癌 急腹症 预后 首发症状 

分 类 号：R737.31[医药卫生—肿瘤]