摘要
目的探讨卵巢浆液性交界性肿瘤(serous borderline tumor,SBT)的临床病理学特征及预后因素。方法回顾性分析41例卵巢SBT(经典型28例,微乳头型13例),比较其临床病理学特征。结果经典型和微乳头型两组患者在平均年龄、绝经状况、肿瘤最大径及复发率差异均无显著性。微乳头型SBT在高临床分期(FIGOⅡ/Ⅲ)、双侧卵巢发生、腹水中见肿瘤细胞、卵巢表面累及、微浸润、腹膜种植及淋巴结转移的发生率方面明显高于经典型SBT(P<0.05)。治疗上微乳头型SBT患者多同时行子宫切除术、部分大网膜切除术和盆腔淋巴结清扫术,且术后常辅以化疗,并采用PT方案。经典型SBT患者常保留卵巢和生育功能。微乳头型SBT常伴乳头状输卵管上皮增生(papillary tubal hyperplasia,PTH)。结论微乳头型SBT与腹膜种植(尤其浸润性种植)及淋巴结转移显著相关,主张进行包括盆腔淋巴结清扫的完整手术分期。两型SBT预后相似,说明微乳头型SBT只是与预后不良因子紧密相关的经典型SBT的形态学变异。
Purpose To evaluate the clinicopathological features and prognostic impact of ovarian serous borderline tumors （SBT）. Methods We retrospectively assessed 41 consecutive patients with typical （n = 28 ） and micropapillary （n = 13 ） SBT. Clinicopatho- logic features and prognostic factors were compared between these two groups. Results There were no significant differences between both groups in mean age, menopausal status, tumor maximum size and recurrence rate. However, the incidences of advanced stage （FIGO Ⅱ/Ⅲ） tumors, site of occurrence （bilateral）, ascites positive cytology, ovarian surface involvement, microinvasion, perito- neal implants and lymph node involvement were significantly higher in patients with micropapillary than with typical SBT （ P 〈 0.05 ）. For surgical procedures, hysterectomy, pelvic lymph node dissection and omentectomy were more commonly performed in patients with micropapillary SBT. Patients with typical SBT more underwent fertility-sparing or ovary-sparing procedures. After surgery, patients with micropapillary SBT more received adjuvant chemotherapy, with most receiving taxane/platinum-based chemotherapy. And mieropapil- lary SBT more accompanied with papillary tubal hyperplasia. Conclusions Because micropapillary SBT are significantly associated with peritoneal implants （especially invasive implants ） and lymph node involvement, complete staging procedures including lymph node dissection are recommended. The prognostic similarity between these two groups demonstrates that micropapillary SBT are just morphologic variation of the typical ones which are associated with factors related with poor prognosis.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2013年第6期615-620,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
南京军区面上课题(07M084)
