卵巢恶性生殖细胞肿瘤保留生育功能手术的系统评价  

A Systematic Review for the Preserve Fertility Surgery in Malignant Ovarian Germ Cell Tumor

作　　者：韦任姬[1] 李力[2] 

机构地区：[1]广西医科大学附属肿瘤医院妇瘤科,南宁530021 [2]贵港市人民医院妇二科

出　　处：《国际妇产科学杂志》2014年第4期379-383,共5页Journal of International Obstetrics and Gynecology

摘　　要：目的：系统评价保留生育功能手术治疗卵巢恶性生殖细胞肿瘤（malignant ovarian germ cell tumor， MOGCT）的生存率、复发率和术后妊娠情况。方法：计算机检索PubMed等外文及维普等中文数据库，纳入符合标准的病例对照研究进行质量评价，对同质性研究采用RevMan 5.1软件进行Meta分析。结果：共纳入11个保留生育功能手术和根治性手术治疗MOGCT生存率比较的回顾性病例对照试验。Meta分析结果表明，MOGCT保留生育功能手术生存率优于根治性手术，差异有统计学意义（OR=1.88，95%CI为1.32～2.69，P=0.0005）。MOGCT保留生育功能手术患者较根治性手术患者复发率低，差异有统计学意义（OR=0.11，95%CI为0.03～0.38，P=0.0007）。4篇临床病例研究详细记录和分析了有生育要求并尝试妊娠和实际成功受孕的例数，总妊娠率为86.7%。结论：保留生育功能手术治疗MOGCT患者的生存率均优于根治性手术患者，复发率低，且能维持正常的妊娠和生育功能，提高患者生存质量。Objective：To evaluate the survival rate, recurrence rate and postoperative pregnancy after fertility preservation operation in patients with malignant ovarian germ cell tumor. Methods：We searched for studies in PubMed and VIP database et al,case control study which conformed to the standards was included and finished quality evaluation. The homogeneity study used RevMan 5.1 software for Meta analysis. Results：We identified 11 retrospective case control trial,which described fertility preservation operation and radical operation in malignant ovarian germ cell tumor and compared their survival. The Meta analysis results：patients with malignant ovarian germ cell tumors after fertility-sparing surgery had a better survival rate than the radical operation ones, the difference was statistically significant （OR=1.88,95%CI：1.32-2.69,P=0.000 5）. Malignant ovarian germ cell tumors with preservation of fertility with lower recurrence rate than patients not to preserve fertility operation, the difference was statistically significant （OR=0.11,95%CI：0.03-0.38,P=0.000 7）. Only 4 clinical case studies detailed record and analyzed the number of patients who trying to get pregnant and actual successful pregnancy ,and calculate the total pregnancy rate was 86.7%. Conclusions：Preserve fertility operation had a better survival rate and recurrence rate than the radical operation patients with ovarian malignant germ cell tumor ,could maintain the reproductive function and normal pregnancies,improved the quality of patients life.

关 键 词：卵巢肿瘤 META分析 生育力 妇科外科手术 卵巢恶性生殖细胞肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]