早期上皮性卵巢癌保留生育功能手术患者预后与妊娠状况的影响因素  

Prognostic factors for oncology and fertility outcomes of early stage epithelial ovarian cancer patients who accepted fertility-sparing surgery

作　　者：张颖[1] 杨佳欣[1] 曹冬焱[1] 俞梅[1] 沈铿[1] 黄惠芳[1] 潘凌亚[1] 吴鸣[1] 郎景和[1] 游燕[2] ZHANG Ying1 , YANG Jiaxin1 , CAO Dongyan1 , YU Mei1 , SHEN Keng1 , HUANG Huifang1 , PAN Lingya1 , WU Ming1 , LANG Jinghe1 , YOU Yan2(1. Department of Obstetrics and Gynecology; 2. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science ＆ Peking Union Medical College, Beijing 100730, Chin)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院妇产科,北京100730 [2]中国医学科学院北京协和医学院北京协和医院病理科,北京100730

出　　处：《山东大学学报（医学版）》2018年第5期13-17,共5页Journal of Shandong University:Health Sciences

基　　金：国家科技部十一五国家科技支撑计划(2008BAI57B02)

摘　　要：目的探讨保留生育功能手术(FSS)治疗早期上皮性卵巢癌(EOC)的可行性及影响患者预后和生育状况的因素。方法回顾性分析接受FSS治疗的EOC患者38例,记录年龄、初次手术方式、病理类型、组织学分级、临床分期及初治后是否化疗等可能影响因素,对其术后生存、复发及妊娠生育情况进行分析。结果中位随访时间90.5个月。5年总体生存率97%,5年无进展生存率80%。随访期间复发率28.9%。组织学分级(G2/G3)是影响无进展生存期的惟一独立危险因素(χ2=39.36,P<0.001);ⅠA期和ⅠC1/ⅠC2期患者的总体生存率及无进展生存率差异无统计学意义(P>0.05);治疗后有生育条件的患者妊娠率为62.5%,活产率40.6%。术后妊娠率不受年龄、手术方式、临床分期、初治后是否化疗和是否复发等因素影响。结论 FSS可用于早期EOC患者,其总体肿瘤预后及妊娠状况较好,组织学分级是影响生存及复发的高危因素。Objective To investigate the influencing factors of tumor and fertility prognosis for patients with early stage epithelial ovarian cancer（EOC） who accepted fertility-sparing surgery（FSS）. Methods A retrospective study was done on the clinical data of 38 patients with EOC who had undergone FSS to assess the influencing factors such as age,surgery,pathological type,histological grade,clinical stage,or chemotherapy after the surgery,on the clinical and fertility outcomes. Results The median time of follow-up was 90. 5 months. The 5-year overall survival（OS） rate and5-year progression-free survival（PFS） rate was 97% and 80%,respectively,while the rate of relapse was 28.9%. Only grade G2/G3 influenced PFS significantly（χ2= 39. 36,P〈 0. 001）. No significant difference was found between stageⅠA and ⅠC1/ⅠC2（P〉0.05）. The conception rate was 62.5%,and 40.6% of the patients had live birth. Fertility outcomes were not influenced by age,surgery,FIGO stage,chemotherapy or relapse. Conclusion Conservative treatment for early EOC patients can be performed reasonably because of the good outcomes of tumor and fertility prognosis. Histological grade is risk factor that should be considered for the patients＇ treatment.

关 键 词：上皮性卵巢癌 保留生育功能 手术 预后因素 生育状况 

分 类 号：R737.31[医药卫生—肿瘤]