本文選題：卵巢惡性畸胎瘤 + 未成熟畸胎瘤�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:通過對46例卵巢惡性畸胎瘤臨床病例資料的整理和回顧性分析,統(tǒng)計并分析卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤惡變的臨床特征、病理特征、臨床分期、治療方案及預(yù)后情況,同時對影響卵巢惡性畸胎瘤預(yù)后的因素進(jìn)行統(tǒng)計學(xué)分析,積累臨床經(jīng)驗,為規(guī)范化治療提供依據(jù)。方法:收集吉林大學(xué)第一醫(yī)院于2010年1月至2017年1月間收治的46例卵巢惡性畸胎瘤患者的臨床病例資料,包括24例卵巢未成熟畸胎瘤和22例卵巢成熟畸胎瘤惡變。所有患者均行手術(shù)治療并經(jīng)病理確診,統(tǒng)計并分析卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤惡變的臨床特征、病理特征、臨床分期、治療方案及預(yù)后情況。運用SPSS19.0(IBM)統(tǒng)計軟件進(jìn)行分析,應(yīng)用t檢驗比較卵巢未成熟畸胎瘤與卵巢畸胎瘤惡變兩組分組資料的差異。應(yīng)用Kaplan-Meier生存分析法和Log-rank檢驗進(jìn)行卵巢惡性畸胎瘤的預(yù)后因素分析,應(yīng)用χ2檢驗進(jìn)行卵巢成熟畸胎瘤惡變的預(yù)后因素分析,從而探究卵巢惡性畸胎瘤患者預(yù)后相關(guān)因素。結(jié)果:1.卵巢未成熟畸胎瘤患者的年齡范圍7歲—45歲,平均年齡為24.50±9.35歲,中位年齡25.50歲。卵巢成熟畸胎瘤惡變患者的年齡范圍23歲—71歲,平均年齡為46.91±13.90歲,中位年齡47.50歲。應(yīng)用t檢驗比較卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤惡變的年齡分布差異,顯示兩者的年齡分布差異有統(tǒng)計學(xué)意義(P0.001)。2.卵巢惡性畸胎瘤患者的臨床表現(xiàn)無特異性,以腹痛、體檢發(fā)現(xiàn)多見。3.卵巢未成熟畸胎瘤患者中臨床分期I期患者23例(95.83%),IV期患者1例(4.17%)。卵巢成熟畸胎瘤惡變患者中臨床分期I期患者18例(81.82%),II期患者1例(4.55%),III期患者3例(13.64%)。卵巢成熟畸胎瘤惡變患者根據(jù)惡變病理類型劃分,鱗癌8例(36.36%),類癌9例(40.91%),腺癌2例(9.09%),其他3例(13.64%)。4.46例卵巢惡性畸胎瘤患者的腫瘤最大徑在2.5cm-22cm之間不等,其中24例卵巢未成熟畸胎瘤患者的腫瘤最大徑平均值為10.04±4.18cm,22例卵巢成熟畸胎瘤惡變患者的腫瘤最大徑平均值為8.54±4.34cm。應(yīng)用t檢驗比較卵巢未成熟畸胎瘤和卵巢成熟畸胎瘤惡變的腫瘤最大徑差異,顯示兩者的腫瘤最大徑差異無統(tǒng)計學(xué)意義(P=0.2490.05)。5.卵巢惡性畸胎瘤患者按年齡國際分組標(biāo)準(zhǔn)分組,應(yīng)用Kaplan-Meier法分析,Log-rank檢驗顯示青年組與中年組的生存時間差異有統(tǒng)計學(xué)意義(P=0.0450.05),青年組與老年組的生存時間差異有統(tǒng)計學(xué)意義(P=0.0020.05)。6.卵巢惡性畸胎瘤患者根據(jù)臨床分期分為I期(40例)和II期及以上(5例)兩組,應(yīng)用Kaplan-Meier法分析,Log-rank檢驗顯示腫瘤臨床分期I期組與II期及以上組的生存時間差異有統(tǒng)計學(xué)意義(P0.001)。7.卵巢惡性畸胎瘤患者根據(jù)病理類型分為卵巢未成熟畸胎瘤組(24例)和卵巢成熟畸胎瘤惡變組(21例),應(yīng)用Kaplan-Meier法分析,Log-rank檢驗顯示卵巢未成熟畸胎瘤組與卵巢成熟畸胎瘤惡變組的生存時間差異有統(tǒng)計學(xué)意義(P=0.01230.05)。8.應(yīng)用χ2檢驗對卵巢成熟畸胎瘤惡變患者的年齡、臨床分期、惡變病理類型進(jìn)行預(yù)后因素分析,顯示卵巢成熟畸胎瘤惡變的臨床分期對預(yù)后影響差異有統(tǒng)計學(xué)意義(P0.001),年齡、惡變病理類型對預(yù)后影響差異無統(tǒng)計學(xué)意義。結(jié)論:1.卵巢未成熟畸胎瘤多見于青年女性,與卵巢成熟畸胎瘤惡變的年齡分布不同。2.卵巢惡性畸胎瘤的臨床表現(xiàn)以腹痛、體檢發(fā)現(xiàn)多見,臨床分期多為I期。3.卵巢成熟畸胎瘤惡變的病理類型以鱗癌、類癌多見,卵巢成熟畸胎瘤惡變的預(yù)后與臨床分期有關(guān)。4.卵巢惡性畸胎瘤的預(yù)后與初治年齡、臨床分期、病理類型有關(guān),卵巢未成熟畸胎瘤的預(yù)后較好。
[Abstract]:Objective: to analyze and analyze the clinical data of 46 cases of ovarian malignant teratoma, and to analyze the clinical features, pathological features, clinical stages, treatment and prognosis of ovarian immature teratoma and mature teratoma of ovary, and to analyze the prognostic factors of ovarian malignant teratoma, and to analyze the factors that affect the prognosis of ovarian malignant teratoma. Clinical experience was accumulated to provide the basis for standardized treatment. Methods: the clinical data of 46 patients with malignant ovarian teratoma treated in No.1 Hospital of Jilin University from January 2010 to January 2017 were collected, including 24 cases of ovarian immature teratoma and 22 cases of malignant ovarian teratoma. All patients underwent surgical treatment and were confirmed by pathology. The clinical features, pathological features, clinical stages, treatment schemes and prognosis of ovarian immature teratoma and ovarian mature teratoma were analyzed and analyzed. The SPSS19.0 (IBM) statistical software was used to analyze the difference between the two groups of ovarian immature teratoma and ovarian teratoma in the two groups. The application of Kaplan-Meie The prognostic factors of ovarian malignant teratoma were analyzed by R survival analysis and Log-rank test. The prognostic factors of ovarian mature teratoma were analyzed by chi 2 test, and the prognostic factors of ovarian malignant teratoma were investigated. Results: the age range of 1. ovarian immature teratoma patients was from 7 to 45 years, with an average age of 24.50 +. The age range of 9.35 years was 25.50 years old. The age range of ovarian mature teratoma patients was 23 years to 71 years old, the average age was 46.91 + 13.90 years and the median age was 47.50 years. T test was used to compare the age distribution of ovarian immature teratoma and ovarian mature teratoma, which showed that the difference of age distribution in two cases was statistically significant (P0.001).2 The clinical manifestations of ovarian malignant teratoma were unspecific, with abdominal pain, 23 patients with.3. ovarian immature teratoma (95.83%), 1 cases (4.17%) in IV stage, 18 (81.82%) of I patients with ovarian mature teratoma, 1 (4.55%) in II stage, 3 in III phase (13.64%). The patients with malignant ovarian teratoma were divided according to the malignant pathological type, 8 cases (36.36%), 9 cases (40.91%), 2 cases of adenocarcinoma (9.09%), and 3 cases (13.64%) of.4.46 cases with malignant ovarian teratoma, the maximum diameter of the tumor was between 2.5cm-22cm, and the average maximum diameter of the 24 cases of ovarian immature teratoma was 10.04 + 4.18. Cm, the maximum diameter of the 22 cases of ovarian mature teratoma was 8.54 + 4.34cm., the maximum diameter difference between the ovarian immature teratoma and the ovarian mature teratoma was compared with the t test. The difference of the maximum diameter between the ovarian immature teratoma and the ovarian mature teratoma was not statistically significant (P=0.2490.05).5. ovarian malignant teratoma patients were divided according to the age international division. Group standard group, Kaplan-Meier analysis, Log-rank test showed that the survival time difference between the young group and the middle-aged group was statistically significant (P=0.0450.05), the difference of survival time between the young group and the elderly group was statistically significant (P=0.0020.05).6. ovarian malignant teratoma patients were divided into I phase (40 cases) and II phase and above (5 cases). The two group, Kaplan-Meier analysis, Log-rank test showed that the difference of survival time between I phase group and II stage and above group was statistically significant (P0.001).7. ovarian malignant teratoma was divided into ovarian immature teratoma group (24 cases) and egg nest mature teratoma malignant change group (21 cases), and Kaplan-Meier method was applied. Analysis, Log-rank test showed that the difference of survival time between the ovarian immature teratoma group and the ovarian mature teratoma group was statistically significant (P=0.01230.05).8. application x 2 test was used to analyze the age, clinical stage and malignant pathological type of ovarian mature teratoma patients, which showed the malignant change of ovarian mature teratoma. There was significant difference in the effect of bed staging on prognosis (P0.001), age and malignant pathological type had no statistical significance on prognosis. Conclusion: 1. ovarian immature teratoma is mostly seen in young women, and the age distribution of ovarian mature teratoma is different from that of.2. ovarian malignant teratoma with abdominal pain, and physical examination is more common. The pathological types of I stage.3. mature teratoma are squamous cell carcinoma. The prognosis of ovarian mature teratoma and the prognosis of ovarian mature teratoma are related to the prognosis of.4. ovarian malignant teratoma, which is related to the primary treatment age, clinical stage and pathological type, and the prognosis of ovarian immature teratoma is better.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.31

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本文編號：1822582