摘要
目的 探讨卵巢泡膜细胞瘤的临床特征、治疗和预后。方法 回顾性分析了我院195 8～ 1998年诊治的 74例卵巢良、恶性泡膜细胞瘤患者的临床和病理资料。结果 74例中 ,恶性泡膜细胞瘤 8例 ;良性泡膜细胞瘤 6 6例 ,其中 9例伴细胞生长活跃。临床症状有腹部包块者 42例(5 6 8% ) ,其次为月经不调、阴道不规则出血、闭经、腹痛、不孕等 ;2 2例合并腹水 ,其中 1例同时伴有胸水 ;39例合并雌激素刺激相关疾病 ,包括子宫内膜癌和内膜不典型增生各 1例 ,子宫肌瘤、内膜复合性增生、内膜息肉等。 6 6例良性泡膜细胞瘤中 ,15例行CA12 5检查 ,9例增高 ;9例伴细胞生长活跃的患者中 ,肿瘤侵犯周围组织和术后复发各 1例 ,经手术和放射治疗 (放疗 ) ,至今已无瘤生存 11年和 2 7年。 8例恶性泡膜细胞瘤中 ,4例因放弃或进行不规范治疗者均在 2年内死亡 ;另 4例 (Ⅰ、Ⅱb期各 1例 ,复发 2例 )经积极手术后行放疗或化学药物治疗 (化疗 ) ,除 1例死于放射性肠瘘外 ,2例无癌生存10年以上 ,1例无癌生存 2年。结论 良性泡膜细胞瘤预后好 ,但应警惕伴细胞生长活跃者。恶性泡膜细胞瘤预后差 ,但积极手术后行放疗或化疗 ,可明显延长生存时间。
Objective To study the clinical pathologic characteristics, treatment and prognostic factors of ovarian thecoma Methods From 1958～1998, a total of 74 patients with benign and malignant thecoma were retrospectively analyzed Results The reviewed diagnosis were 8 patients with malignant thecoma, 66 patients were benign thecoma Nine of 66 patients with benign thecoma appeared cell proliferative activity The mean age was 52 years The most frequent symptoms were abdominal pelvic masses (56 8%), metromenorrhagia and abnormal vaginal bleeding, other symptoms were abdominal pain, infertility followed Twenty two of 66 patients had ascites, only 1 patient with ascites and hydrothorax sinultaneously Thirty nine patients with diseases which associate with excessive estrogenic stimulation, including 1 endometrial adenocarcinoma and 1 endometrial dysplasia and other diseases such as: myoma; endometrial hyperplasia and polyp Fifteen patients with benign thecoma were evaluated blood serum CA 125 , the CA 125 were elevated in 9 of 15 patients In 2 of 9 patients with cell proliferative activity, the tumors invaded adjacent tissues or relapsed, after received operation and pelvic radiotherapy, they are alive 11 years and 27 years respectively Among 8 patients with malignant thecoma, 4 patients without postoperation therapy or with non standard chemotherapy died in 2 years postoperation, the other 4 patients received operation, postoprational radiotherapy or(and) chemotherapy, 1 of 4 patients died of irradiation intestinal fistule 4 years later; two patients are alive without disease more than 10 years, another one for 2 years Conclusions Theca cell tumor of ovary have good prognosis, but we should pay attention to thecomas with proliferative activity The prognosis of malignant thecomas is poor, postoperative systemic chemotherapy or radiotherapy to the patients with malignant thecomas can improve their survival
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2002年第2期101-103,共3页
Chinese Journal of Obstetrics and Gynecology
