摘要
目的:探讨卵巢恶性生殖细胞肿瘤的临床特征与预后的关系。方法:收集我院2006年8月至2012年2月收治的42例卵巢恶性生殖细胞肿瘤的临床资料,分析其肿瘤类型、分期、治疗方案等预后相关因素,研究其临床特征与不良预后的关系。结果:42例卵巢恶性生殖细胞肿瘤包括混合性生殖细胞肿瘤16例(38.1%)、未成熟畸胎瘤12例(28.6%)、无性细胞瘤6例(14.3%),卵黄囊瘤4例(9.5%)、绒毛膜癌1例(2.4%)及胚胎癌1例(2.4%)等。42例患者全部进行手术治疗,其中30例在初次手术中保留了生育功能,34例在术后给予BEP方案(博来霉素+依托泊苷+顺铂)或BVP方案(博来霉素+长春新碱+顺铂)化疗。2年生存率97.5%(39/40),死亡1例(Ⅳ期混合性生殖细胞肿瘤),复发率37.5%(15/40),混合性生殖细胞肿瘤复发占66.7%(10/15);5年生存率88.2%(15/17),死亡2例(均为恶性混合性生殖细胞肿瘤)。不同病理分期、肿瘤直径、肿瘤类型和手术方式的5年生存率比较,差异均无统计学意义(P>0.05)。结论:保留生育功能手术及规范化的BEP或BVP方案化疗,5年总体生存率较高,但混合性生殖细胞肿瘤预后相对较差。卵巢恶性生殖细胞肿瘤的病理分期、肿瘤直径及肿瘤类型与生存率的关系还需进一步研究。
Objective： To investigate the relationship between clinical features and prognosis of malignant ovarian germ cell tumors. M ethods： The clinical data of 42 cases of malignant ovarian germ cell tumor admitted in the hospital during August 2006 to February 2012 were reviewed,and the relationship between the clinical characteristics and prognosis were studied. Results： There were 16 cases of mixed germ cell tumors（ 38. 1%）,12 cases of immature teratoma（ 28. 6%）,6 cases of dysgerminoma（ 14. 3%）,4 cases of endodermal sinus tumor（ 9. 5%）,1case（ 2. 4%） of choriocarcinoma and 1 case（ 2. 4%） of embryonic carcinoma. All patients underwent surgical treatment,including 30 cases of primary fertility preserving surgery. 34 cases underwent post-operative chemotherapy with BEP or BVP regimen. The 2-year survival rate was 97. 5%（ 39 /40）,and one patient died with mixed germ cell tumor stage IV. The 2-year recurrence rate was 37. 5%（ 15 /40） which mixed germ cell tumor accounted for 66. 7%（ 10 /15）. The 5-year survival rate was 88. 2%（ 15 /17）,and two patients died with mixed germ cell tumor. There was no significant difference（ P〉0. 05）,between the 5-year survival rate and different pathological staging,tumor size,tumor type or operation mode. Conclusions： With the fertility preserving operation and chemotherapy of BEP / BVP,the overall 5-year survival rate of germ cell tumor was good,but the mixed germ cell tumor had a relatively poor prognosis. The relationship between prognosis and pathology staging,tumor volume,and tumor types needs to be stuied.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2015年第1期40-44,共5页
Journal of Practical Obstetrics and Gynecology
