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Krukenberg瘤是一种较少见的转移性卵巢恶性肿瘤。本文根据文献分析,深入探讨了Krukenberg瘤的认识历史、发病机制、临床病理特征、诊断、治疗及预后。Krukenberg瘤最可能的发病机制是胃肠道癌的逆行淋巴道转移,常见的原发瘤部位依次为胃、结直肠、阑尾、胆囊/胆管、小肠、胰腺,30-49岁绝经前妇女发病最多。其诊断要点有:①近3年内有胃肠癌病史;②双侧卵巢同时发生实质性肿瘤;③CA-125升高;④CK7-1/CK20+或CK7+/CK20+。治疗以根治性切除原发灶和转移灶为主,以铂类和氟脲嘧啶类为主的辅助化疗有一定的临床受益。Krukenberg瘤多预后不良,根治性切除是改善预后的关键因素,而年龄、绝经状态、肿瘤大小、分期、组织类型、放化疗及治疗后无复发生存时间与预后的关系尚有待进一步研究。
Krukenberg’s tumor is a rare metastatic ovarian cancer. Based on the literature analysis, this article explores the history, pathogenesis, clinicopathological features, diagnosis, treatment and prognosis of Krukenberg’s tumor. The most likely pathogenesis of Krukenberg’s tumor is retrograde lymphatic metastasis of gastrointestinal cancer. The most common primary tumor sites are gastric, colorectal, appendix, gallbladder / bile duct, small intestine and pancreas, and most premenopausal women aged 30-49 . The diagnostic points are: ① nearly three years history of gastrointestinal cancer; ② bilateral ovarian tumors occur simultaneously; ③ CA-125 increased; ④ CK7-1 / CK20 + or CK7 + / CK20 +. The treatment of radical resection of the primary tumor and metastases based platinum and fluorouracil-based adjuvant chemotherapy have some clinical benefits. Krukenberg tumor with poor prognosis, radical resection is the key factor to improve prognosis, and the relationship between age, menopause, tumor size, stage, type of tissue, chemoradiotherapy and postoperative recurrence-free survival remains to be further studied.