165例卵巢恶性肿瘤不全分期术后行再分期手术必要性的临床初探  

Clinical study on the necessity of re-staging after incomplete staging in 165 cases of ovarian malignant tumor

作　　者：刘亚娜 郭瑞霞[1] 毛萌[1] 白晶[1] 王倩[1] 褚丹霞 赵孟玲 李留霞[1] 赵倩[1] LIU Yana;GUO Ruixia;MAO Meng;BAIJing;WANG Qian;CHU Danxia;ZHAO Mengling;LI Liuxia;ZHAO Qian(Department of Gynecology and Obstertrics,The First Affiliated Hospital of Zhengzhou University,Zhenghzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇产科,450052

出　　处：《中国妇产科临床杂志》2022年第4期351-354,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：中原千人计划-中原名医(ZYQR201810107);中青年卫生健康科技创新人才(领军)(YXKC2020012)。

摘　　要：目的探讨卵巢上皮性癌、恶性生殖细胞肿瘤、恶性性索间质肿瘤不全分期术后行再分期手术的必要性。方法回顾性分析2013年1月至2021年1月在郑州大学第一附属医院收治的165例不全分期中手术分期为早期(ⅠA~ⅠC期)卵巢恶性肿瘤患者行再分期手术的临床资料。其中上皮性癌组85例,恶性生殖细胞肿瘤组31例,恶性性索间质肿瘤组49例。手术获益患者定义为再分期术后手术-病理分期升高患者。结果上皮性癌组再分期手术总获益率为36.47%(31/85),明显高于生殖细胞肿瘤组(9.68%,3/31)及性索间质肿瘤组(4.08%,2/49),差异有统计学意义(P<0.05)。不全分期术中医师未怀疑存在病灶残留的上皮性癌、生殖细胞肿瘤、性索间质肿瘤患者行再分期手术获益率分别为33.33%(27/81)、3.44%(1/29)及0%(0/47),均明显低于不全分期术中医师怀疑存在病灶残留者(P<0.05);再分期术前影像学无阳性发现的上皮性癌、生殖细胞肿瘤、性索间质肿瘤患者再分期手术获益率分别为34.15%(28/82)、3.44%(1/29)及2.08%(1/48),均显著低于再分期术前影像学存在阳性发现者(P<0.05)。结论不全分期中手术分期为早期的卵巢上皮性癌患者术后应行再分期手术;不全分期中手术分期为早期的卵巢生殖细胞肿瘤及性索间质肿瘤患者,若术中有肿瘤残留或再分期术前影像学存在阳性发现,有必要行再分期手术。Objective To investigate the necessity of the re-staging operation after incomplete staging of epithelial cancer,ovarian malignant germ cell tumor and sex cord stromal tumor.Methods A retrospective analysis was made on 165ovarian cancer patients with surgical stageⅠA~ⅠC after incomplete staging operation who underwent re-staging operation in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2021.There were 85 cases in the epithelial carcinoma group,31 cases in the malignant germ cell tumor group and 49 cases in the malignant sex cord stromal tumor group.Results The rate of benefit from re-staging operation(surgical-pathological staging upgraded after re-staging operation)was 36.47%(31/85)in the epithelial cancer group,which was significantly higher than that in the germ cell tumor group(9.68%,3/31)and sex cord stromal tumor group(4.08%,2/49),the difference was statistically significant(P<0.05).The rates of benefit from re-staging operation among epithelial cancer,germ cell tumor and sex cord stromal tumor patients who had no residual impression tumor in incomplete staging operation are 33.33%(27/81),3.44%(1/29)and 0%(0/47),which are significantly lower than that in the patients who had residual impression tumor in incomplete staging operation(P<0.05);The rates of benefit from re-staging operation among epithelial cancer,germ cell tumor and sex cord stromal tumor patients who had no positive imaging findings before re-staging are 34.15%(28/82),3.44%(1/29)and 2.08%(1/48),which are significantly lower than that in the patients who had positive imaging findings before re-staging(P<0.05).Conclusion The epithelial ovarian carcinoma with early surgical stage in incomplete staging operation should be treated with re-staging surgery after incomplete staging surgery;When there are residual tumor in incomplete staging operation or positive imaging findings before re-staging in the early surgical stage germ cell tumors and in the early surgical stage sex cord stromal tumors,it is necessar

关 键 词：卵巢恶性肿瘤 不全分期手术 再分期手术 手术获益 

分 类 号：R737.31[医药卫生—肿瘤]