摘要
目的探讨卵巢表面浆液性交界性乳头状瘤（serous surface papillary borderline tumor,SSPBT）患者的临床特征。方法回顾性分析2010年1月1日至2012年6月1日复旦大学附属妇产科医院妇科19例SSPBT患者的临床资料,分析总结其临床特征及随访情况。结果 19例SSPBT患者中,年龄25~55岁,平均（36.3±10.8）岁;无明显临床症状,多在体检或不孕检查时发现＂盆腔包块＂,部分患者有腹胀腹痛不适、阴道流血,或因手术时意外发现。有生育史患者9例,平均产次为（1.22±0.44）次,有生育要求患者11例。超声诊断卵巢肿瘤的检出率为88.24%,肿瘤最大径线平均值为（87±27.16）mm,多表现为中低、中等或混合回声。94.11%患者血清CA125水平升高,43.75%患者血清CA19-9水平升高,所有患者血清癌胚抗原水平在正常参考区间内。19例患者中双侧卵巢SSPBT占84.21%,典型者可见卵巢表面赘生物,多呈菜花样、乳头状、粟粒样等表现,部分患者卵巢表现为囊性增大或表面组织增生。8例患者经腹腔镜手术,11例患者经腹手术,11例为Ⅰc期,3例为Ⅲb期,5例为Ⅲc期;7例行保留生育功能手术,5例行全子宫加双附件切除术,7例行肿瘤分期手术,有8例患者术后辅助化疗,其中铂类＋紫杉醇类3例,铂类＋多西他赛5例;14例患者随访至2014年11月,2例保留生育功能患者复发,其中1例因复发2次行患侧附件切除术,1例术后因不孕行体外受精-胚胎移植术后复发,2例成功生育,12例无复发。结论 SSPBT是特殊的卵巢交界性浆液性肿瘤,多为双侧,患者多有生育要求,以手术治疗为主,但保守性手术存在复发风险,无生育要求患者可行全子宫双附件切除术或行全面的肿瘤分期手术。
Objective To clarify the borderline tumor （SSPBT）. Methods clinical features and prognosis of serous surface papillary By performing a retrospective analysis, we studied 19 women with SSPBT between Jan. 1st , 2010 and Jun. 1st,2012 from Obstetrics and Gynecology Hospital of Fudan University to analyze their clinical imformation and follow-up. Results Of the 19 women, the median age was （36.3 ± 10.8） years old （range 25-55）. Most of them didn＇t have obvioussymptoms,and some women might have abdominal distension, bellyache or viginal bleeding. The pelvic mass was usually discovered unexpectedly by health check-up or in operation. Nine women had childbearing history, and the median number of parity was 1.22 ±0.44. Eleven rad bearing requirement. The accuracy rate of ultrasound for detection of the ovarian mass of SSPBT was 88.24%. The median diameter of the mass was （87 ± 27. 16） mm. Most masses displayed medium or low or mix echo in ultrasound. 94.11% of the patients accompanied with elevated level of CA125, and 43. 75%of them accompanied with elevated level of CA19-9. Among all the patients, the level of carcinoembryonic antigen was normal. Both ovaries were involved in 84. 21% of the cases studied. The ovaries involved were usually covered by neoplasm like cauliflower, papillary or millet, and some others manifested cycstic ovaries or hyperblastosis. Eight women underwent laporascopy and eleven underwent laparotomy in our study. Eleven women were in stage Ie, three were in stage IIIb and five were in stage IIIc. Seven women underwent fertility-sparing surgery, five underwent hysterectomy and bilateral salpingo-oopherectomy, seven underwent comprehensive staging laparotomy. Among the patients, 8 women followed with chemotherapy, including platinum plus paclitaxel （n = 3） or platinum plus docetaxel （n = 5）. Fourteen women＇s follow-ups were analysed until Nov. , 2014. Two patients relapsed. One of them underwent unilateral salpingo-oopherectomy after its second replase and the other on
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2015年第4期533-537,共5页
Fudan University Journal of Medical Sciences
