摘要
目的分析青春期少女卵巢生殖细胞肿瘤的临床特征,探讨其诊断和治疗方法。方法回顾性分析我院1999年1月至2005年12月收治的68例10～19岁(平均为16.34岁)青春期卵巢生殖细胞瘤患者的临床表现、病理特点和诊疗资料。结果本组患者经手术病理确诊,成熟畸胎瘤59例,无性细胞瘤2例,内胚窦瘤1例,混合型生殖细胞瘤2例,未成熟畸胎瘤4例。59例良性肿瘤患者中,44例行卵巢肿瘤剥出术,15例因卵巢瘤蒂扭转,患侧卵巢坏死而行患侧附件切除术,随访7个月至5年无复发。9例恶性肿瘤患者中,4例a期患者仅行患侧附件切除;2例Ic期患者行患侧附件切除,术后博来霉素+依托泊苷+顺铂(BEP)方案化疗4～6疗程,随访4个月至9年无复发;2例c期患者家人放弃治疗,均在半年左右死于多器官衰竭;1例期患者行腹式全子宫+双附件+大网膜+肿瘤细胞减灭术,术后BEP方案化疗2次,术后3个月死于多器官衰竭。结论卵巢恶性生殖细胞肿瘤可行保留生育功能的手术治疗,术后BEP方案化疗,能够显著改善预后。常规盆腔检查对于及早发现和治疗青春期少女卵巢肿瘤有益。
Objective To study the clinical feature, diagnosis and treatment of ovarian germ cell tumors in adolescent patients. Methods A retrospective analysis was performed on 68 cases aged 10 to 19 years old with ovarian germ cell tumors. Results The average age was 16. 34 years old. All the cases underwent surgical treatment and pathological examination. The histological types included 59 cases of mature teratoma, 2 dysgerminomas, 1 endodermal sinus tumor, 2 mixed germ cell tumors, and 4 immature teratomas. Cystectomy were performed on 44 cases of benign tumor. Unilateral salpingooophorectomy was undertaken in 15 cases with ovary necrosis because of peidicle torsi. Fertility was preserved in 4 cases at stage I malignant ovarian tumors, in which, two stage I c cases received chemotherapy. All of these 65 cases are alive without evidence of disease recurrence during the follow-up. Two stage Ⅲ c and one stage IV cases died in 6 and 3 months with following treatment. Conclusion The conservative operation should be adopted to preserve fertility in patients with malignant ovarian germ cell tumor. Schedule examination of the reproductive system in young girls can detect ovarian tumor in an early stage, so it may play a very important role in successful treatment.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2007年第5期258-260,共3页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
