正常大小卵巢癌综合征的临床诊疗分析  

Clinical Diagnosis and Treatment Analysis of Normal-sized Ovary Carcinoma Syndrome

作　　者：朱彤[1] 张楚 边欣怡 刘丽婷 刘洪 汪辉 余楠 ZHU Tong;ZHANG Chu;BIAN Xin-yi;LIU Li-ting;LIU Hong;WANG Hui;YU Nan(Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College of HUST,Wuhan 430030,Hubei,China;Department of Integrated Traditional Chinese and Western Medicine,Tongji Hospital,Tongji Medical College of HUST,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院中西医结合科,湖北武汉430030

出　　处：《医学信息》2021年第8期109-112,共4页Journal of Medical Information

基　　金：国家自然科学基金项目(编号:81701530)。

摘　　要：目的探讨正常大小卵巢癌综合征的临床特点、诊断标准及预后。方法回顾性分析2016年1月~2019年12月在我院治疗及病理证实的35例正常大小卵巢癌综合征患者临床资料,按照组织学来源是否为第二苗勒系统将其分为苗勒组(n=30)与转移组(n=5),比较两组临床表现及预后差异。结果苗勒组年龄、绝经人数高于转移组,差异有统计学意义(P<0.05);两组孕次、产次比较,差异无统计学意义(P>0.05);两组腹痛、阴道流血或流液、体检肿瘤标志物增高、胸闷气促发生率及CA125、CEA比较,差异无统计学意义(P>0.05),苗勒组腹胀发生率、腹水含量高于转移组,CA199低于转移组,差异有统计学意义(P<0.05);苗勒组患者行全子宫切除+双附件切除+大网膜切除+盆腔淋巴结清扫术,转移组患者行全子宫切除+双附件切除+大网膜切除+盆腔淋巴结清扫术;苗勒组主要为卵巢原发肿瘤和卵巢外腹膜浆液性乳头状腺癌,转移组主要为来源于胃、阑尾、直肠、消化道的肿瘤;苗勒组9例误诊,转移组2例误诊;两组存活时间比较,差异无统计学意义(P>0.05)。结论对于正常大小卵巢癌综合征患者,必须高度重视鉴别诊断,尽早手术探查,尽量切除癌灶,术后辅以有效化疗或放疗,以期获得最佳生存期和预后。Objective To explore the clinical features,diagnostic criteria and prognosis of normal-sized ovary carcinoma syndrome.Methods A retrospective analysis of the clinical data of 35 patients with normal-sized ovary carcinoma syndrome who were treated and pathologically confirmed in our hospital from January 2016 to December 2019.According to whether the histological source is the second Mullerian system,they are divided into the Mullerian group(n=30)and the metastasis group(n=5).The differences in clinical manifestations and prognosis between the two groups were compared.Results The number of menopausal women and the age in the Mullerian group were higher than those in the metastasis group,the difference was statistically significant(P<0.05);There was no statistically significant difference in pregnancy times and parity times between the two groups(P>0.05);There was no statistically significant difference between the two groups of abdominal pain,vaginal bleeding or fluid,increased tumor markers in physical examination,chest tightness and shortness of breath,CA125 and CEA(P>0.05).The incidence of abdominal distension and ascites content in the Mullerian group was higher than that in the metastasis group,and CA199 was lower than that in the metastasis group,the difference was statistically significant(P<0.05);Patients in the Mullerian group underwent total hysterectomy+double attachment resection+omentectomy+pelvic lymph node dissection,and patients in the metastasis group underwent total hysterectomy+double attachment resection+omentectomy+pelvic lymph node dissection;The Mullerian group was mainly ovarian primary tumors and extraovarian peritoneal serous papillary adenocarcinoma,and the metastatic group was mainly tumors from the stomach,appendix,rectum,and digestive tract;Nine cases were misdiagnosed in the Mullerian group and 2 cases were misdiagnosed in the metastasis group.There was no significant difference in survival time between the two groups(P>0.05).Conclusion For patients with normal-sized ovary carcinoma

关 键 词：卵巢肿瘤 正常大小卵巢癌综合征 第二苗勒系统 转移肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]