32例卵巢交界性上皮性肿瘤临床病理分析  

Clinicopathological analysis on the features of borderline epithelial ovarian tumor in 32 cases

作　　者：严敏琴 李佳嘉 汪向明 何莲芝 YAN Minqin;LI Jiajia;WANG Xiangming;HE Lianzhi(Department of Obstetrics&Gynecology,The first Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院妇产科,安徽芜湖241001 [2]皖南医学院第一附属医院弋矶山医院病理科,安徽芜湖241001

出　　处：《皖南医学院学报》2018年第2期157-160,共4页Journal of Wannan Medical College

基　　金：安徽省卫生和计划生育委员会科研计划项目(全科医学临床科研课题)(2016QK055)

摘　　要：目的:探讨卵巢交界性上皮性肿瘤(BOTs)的分类及临床病理特征、预后情况。方法:回顾性分析弋矶山医院妇科2006年3月~2016年3月收治的32例BOTs患者的临床病理资料,比较复发率及影响因素。结果:32例BOTs患者平均初诊年龄为(41.0±3.8)岁。病理类型浆液性交界性肿瘤16例,黏液性交界性肿瘤11例,子宫内膜样交界性肿瘤2例,交界性Brenner瘤2例,交界性透明细胞腺纤维瘤1例。运用免疫组化SP法检测32例BOTs组织中CA125、CA199和P53的表达水平,并与16例卵巢上皮性良性肿瘤(浆液性7例,黏液性4例,良性子宫内膜样2例,良性Brenner瘤2例,透明细胞样1例)和6例子宫平滑肌瘤患者正常卵巢组织中CA125、CA199和P53的表达水平进行比较。免疫组化结果示CA125、CA199和P53在32例BOTs组织表达分别为15.6%(5/32)、9.4%(3/32)、6.3%(2/32),CA125、CA199和P53在16例卵巢良性肿瘤组织中的表达分别为0(0/16)、6.3%(1/16)、0(0/16),在正常6例正常卵巢组织中无表达。FIGO分期Ⅰa期25例(78.1%),Ⅰb期6例(18.8%),Ⅰc期1例(3.1%)。保守性手术治疗的病例中,1例Ⅰb期患者于术后半年复发,另1例Ⅰc期患者于术后2年复发;1例根治性手术治疗患者术后1年复发。10例患者术后化疗,未复发。结论:BOTs患者较年轻,发现时多为早期。卵巢交界性上皮性肿瘤预后较好,诊断依靠病理诊断,手术是主要治疗方式,化疗是否有益尚有争议,随访是发现肿瘤复发、提高生存率的重要手段。Objective:To investigate the classification,clinicopathological features and prognosis of borderline epithelial tumors of ovary.Methods:Clinicopathological information was obtained in 32 cases of borderline epithelial ovarian tumor treated in our department between March of 2006 and 2016,and retropestively analyzed to compare the recurrence rate and factors affecting the relapse.Results:The average age at initial diagnosis was(41.0±3.8)years.Pathological types included serous borderline ovarian tumor in 16 cases,mucous borderline tumor in 11,endometrial borderline tumor in 2,Brenner borderline tumor in 2,and transparent cystic neoplasm in 1.Immunohistochemical SP method was used to determine the expression levels of CA125,CA199 and P53 in 32 cases of borderline epithelial ovarian tumor.The levels were compared with those in 16 cases of benign ovarian tumor(7 serous cystadenoma tumor,4 mucous cystadenoma tumor,2 endometrium tumor,2 Brenner tumor,1 transparent cystic neoplasm)and in the normal ovarian tissues obtained from 6 cases of leiomyoma of uterus.The results indicated that CA125,CA199 and P53 expression levels were 15.6%(5/32),9.4%(3/32)and 6.3%(2/32)in the borderline epithelial ovarian tumors,0(0/16),6.3%(1/16)and 0(0/16)in the 16 benign cases,respectively,and free in the normal ovarian tissues.By FIGO stage,25 cases(78.1%)wereⅠa,6(18.8%)Ⅰb,and 1(3.1%)wasⅠc.(1/32).Relapse occurred in one case ofⅠb,and another 1 ofⅠc,six months and two years after radical surgery,respectively.One patient had relapse one year after the radical surgery.No relapse occurred in 10 cases undergone postoperative chemotherapy.Conclusion:Borderline epithelial ovarian tumor can be found in younger age and early diagnosed.This tumor has better prognosis,and its diagnosis primarily relies on pathology and treatment option on surgery.However,chemotherapy is controversial.Careful follow-up can reveal the tumor recurrence and improve the survival rate.

关 键 词：卵巢交界性上皮性肿瘤 临床病理 CA125 CA199 P53 

分 类 号：R737.31[医药卫生—肿瘤]