本文選題：卵巢交界性腫瘤 + 診斷　； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討卵巢上皮性交界性腫瘤(Borderline ovarian tumors)臨床病理學(xué)特征及其復(fù)發(fā)相關(guān)危險(xiǎn)因素。方法:回顧性分析山西省腫瘤醫(yī)院于2001年1月至2015年12月收治的210例BOTs患者的病例資料,分析其臨床特點(diǎn)、術(shù)前檢查、病理學(xué)特點(diǎn)、手術(shù)方式與復(fù)發(fā)相關(guān)危險(xiǎn)因素。結(jié)果:1、210例BOTs患者平均發(fā)病年齡為41±16歲,有生育要求的有56例。2、49.05%(103/210)的患者表現(xiàn)為腹痛、腹脹,38.57%(81/210)的患者無臨床癥狀在體檢時(shí)發(fā)現(xiàn)。3、術(shù)前CA125水平35 IU/ml者91例(48.40%),CA199水平37 IU/ml者53例(30.81%),其升高比例數(shù)在組織學(xué)類型之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。超聲顯示粘液性包塊直徑均數(shù)為17.23cm,漿液性包塊直徑均數(shù)為8.23cm,兩者在包塊直徑大小、多房性上差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4、術(shù)中冰凍診斷準(zhǔn)確率為75.91%(104/137),其中漿液性交界瘤準(zhǔn)確率為89.19%(66/74),粘液性交界瘤準(zhǔn)確率為60%(33/55)。術(shù)中冰凍診斷的準(zhǔn)確性在組織學(xué)類型之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5、術(shù)后最為常見的組織學(xué)類型:漿液性交界瘤86例(40.95%),粘液性交界瘤90例(42.86%),混合乳頭狀瘤21例(10.00%)。病理分期:IA期142例(67.62%),大于IA期68例(32.38%),大部分患者為早期。術(shù)后對II期以上、術(shù)中有囊腫破裂的47例(22.38%)患者進(jìn)行化療。6、術(shù)后平均隨訪時(shí)間61.2個(gè)月中,有23例患者復(fù)發(fā),復(fù)發(fā)率為11.27%。多因素Logistic回歸分析結(jié)果顯示與復(fù)發(fā)相關(guān)的危險(xiǎn)因素有微乳頭型、IA期、年齡(P0.05)。術(shù)后妊娠率為56.60%。結(jié)論:卵巢上皮性交界性腫瘤主要發(fā)生在年輕女性,期別相對較早,預(yù)后良好。卵巢上皮性交界性腫瘤術(shù)前診斷仍然困難。年輕有生育意愿的患者可行保守性手術(shù)治療,術(shù)后妊娠率仍較高。對于微乳頭型、年輕及高期別的患者,術(shù)后復(fù)發(fā)率高,應(yīng)密切隨訪,警惕復(fù)發(fā)。
[Abstract]:Objective: to investigate the clinicopathological features and risk factors of borderline ovarian tumors in ovarian epithelial sexual intercourse. Methods: the data of 210 patients with BOTs admitted in Shanxi Cancer Hospital from January 2001 to December 2015 were analyzed retrospectively. The clinical features, preoperative examination, pathological features, surgical methods and risk factors related to recurrence were analyzed. Results the mean age of onset of BOTs in 1210 BOTs patients was 41 鹵16 years old. No clinical symptoms were found in the patients with abdominal distension of 38.57 / 210. The preoperative CA125 level of 35 IU/ml was found in 91 cases with CA199 level 37 IU/ml in 53 cases with 37 IU/ml, and the proportion of elevation was significantly different between histological types (P 0.05). The mean diameter of mucous mass was 17.23 cm, and the mean diameter of slurry mass was 8.23 cm. The accuracy of intraoperative frozen diagnosis was 75.91%. The accuracy rate of serous borderline tumor was 89.1966 / 74, and the accuracy rate of mucinous borderline tumor was 60.33 / 550.The accuracy of intraoperative frozen diagnosis was 75.91%, and the accuracy of serous borderline tumor was 89.1966 / 74. There was significant difference in the accuracy of intraoperative frozen diagnosis among histological types. The most common histological types were serous borderline tumor in 86 cases, mucinous borderline tumor in 90 cases and mixed papilloma in 21 cases. The most common histological types were serous borderline tumor (n = 86), mucinous borderline tumor (n = 90) and mixed papilloma (n = 21). Pathological stage: IA stage 142 cases (67.62%), larger than IA stage 68 cases (32.38%), most of the patients were early stage. After operation, 47 cases with rupture of cysts above stage II and intraoperative rupture of cysts were treated with chemotherapy .6. the average follow-up time was 61.2 months, 23 cases recurred and the recurrence rate was 11.27%. Multivariate Logistic regression analysis showed that the risk factors associated with recurrence were micropapillary stage IA and age (P0.05). The pregnancy rate was 56.60 after operation. Conclusion: ovarian epithelial borderline tumors mainly occur in young women with relatively early stage and good prognosis. Preoperative diagnosis of ovarian epithelial borderline tumors is still difficult. The pregnant rate of young patients with fertility intention is still high. For other patients with micronipple type, young and high stage, the recurrence rate is high and should be followed up closely and be on the alert for recurrence.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.31

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相關(guān)期刊論文 前5條

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3 趙e，

本文編號(hào)：1924972