20岁以下卵巢肿瘤174例临床分析  

Clinical analysis of 174 cases of ovarian tumors under 20 years old

作　　者：王文婷[1] 徐娟[1] 吕娟[1] WANG Wen-ting;XU Juan;LYV Juan(Department of Gynaecology,Women′s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing 210004,Jiangsu,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)妇科,江苏南京210004

出　　处：《广东医学》2023年第9期1137-1141,共5页Guangdong Medical Journal

基　　金：江苏省第六期“333人才”培养支持项目[(2022)3-1-296号]。

摘　　要：目的分析20岁以下卵巢肿瘤发病规律、临床及病理特点,为早期筛查和诊疗提供医学建议,引起人们对20岁以下女性卵巢肿瘤的重视。方法回顾性分析174例接受手术治疗的年龄20岁以下的卵巢肿瘤患者的临床资料。结果20岁以下卵巢肿瘤大多发生在月经初潮后,月经初潮前后各组织类型的卵巢肿瘤占比不同,尤其上皮性卵巢肿瘤在月经初潮后占比明显降低,差异有统计学意义(P=0.024),月经初潮后卵巢恶性肿瘤的占比也明显降低,差异有统计学意义(P=0.025)。此外,不同性质卵巢肿瘤的大小存在差异(P=0.001),≥10 cm的卵巢肿瘤交界性或恶性的可能性越大。受试者工作特征(receiver operator characteristic,ROC)曲线分析显示:肿瘤大小预测肿瘤性质的曲线下面积(AUC)为0.904(P<0.001),临界值为8.79 cm,在本研究中区别良性、交界性及恶性肿瘤价值高。结论20岁以下女性卵巢肿瘤的发病情况与月经状况密切相关,且肿瘤直径越大,提示交界性或恶性的可能性越大。应该特别注意20岁以下女性月经状况,建议在月经来潮后3~5年内常规进行妇科超声检查,尽早建立诊断,保护生育能力。Objective To analyze the incidence patterns,clinical,and pathological characteristics of ovarian tumors in patients under 20 years of age,and to provide medical recommendations for early screening and diagnosis,raising awareness about ovarian tumors in females below 20 years of age.Methods A retrospective analysis of clinical data was conducted on 174 cases of ovarian tumors in patients under 20 years of age who underwent surgical treatment.Results Ovarian tumors in patients under 20 years of age predominantly occurred after menarche.The proportion of ovarian tumors of different tissue types varied before and after menarche,with a significant decrease in the proportion of epithelial ovarian tumors after menarche(P=0.024).The proportion of malignant ovarian tumors also significantly decreased after menarche(P=0.025).Additionally,there were significant differences in the size of ovarian tumors with different natures(P=0.001),and tumors with a size≥10 cm were more likely to be of borderline or malignant nature.Receiver operator characteristic(ROC)curve analysis showed that the tumor size predicted the nature of the tumor,with an area under the curve(AUC)of 0.904(P<0.001)and a cut-off value of 8.79 cm,indicating high diagnostic value for distinguishing between benign,borderline,and malignant tumors.Conclusion The incidence of ovarian tumors in females under 20 years of age is closely correlated to their menstrual status,and larger tumor diameter indicates a higher possibility of borderline or malignant nature.Special atention should be given to the menstrual status of females under 20 years of age,and routine gynecological ultrasound examinations are recommended within 3-5 years after menarche to establish an early diagnosis and preserve fertility potential.

关 键 词：卵巢肿瘤 20岁以下 月经初潮 生育力 

分 类 号：R737.31[医药卫生—肿瘤]