论文部分内容阅读
目的探讨原发性卵巢类癌的临床特点。方法回顾性分析北京协和医院2002-2007年收治的7例原发性卵巢类癌患者的临床病理资料。结果原发性卵巢类癌十分罕见,占同期收治卵巢癌的0.53%。患者年龄29～64岁,中位年龄35岁;孕次平均2.0次(0～5次);产次平均0.57次(0～1次)。以盆腔包块、便秘、月经紊乱及阴道不规则出血为主要临床表现。妇科检查附件区扪及实性或囊实性包块。CA125轻度升高2例,CA199升高1例。神经内分泌标志物的检测有助于诊断。病理检查证实7例患者均为临床Ⅰ期,单纯类癌3例,类癌合并畸胎瘤3例,甲状腺肿类癌2例。7例患者均行手术治疗,其中保留生育功能者4例,子宫+双附件切除3例。术后1例行BEP方案(顺铂、博莱霉素、足叶乙甙)化疗3个疗程,1例行紫杉醇单药化疗1个疗程。定期随访,除1例失访外,余无复发病例。结论原发性卵巢类癌恶性程度较低,生物学行为较好,不易远处转移,早期病例预后良好。但此肿瘤有远期复发可能,因此应长期随访。
Objective To investigate the clinical features of primary ovarian carcinoid. Methods The clinical and pathological data of 7 patients with primary ovarian carcinoid who were admitted to Peking Union Medical College Hospital during 2002-2007 were retrospectively analyzed. The results of primary ovarian carcinoid is very rare, accounting for 0.53% of ovarian cancer over the same period. Patients aged 29 to 64 years old, the median age of 35 years; the average number of pregnancies 2.0 times (0 ~ 5 times); average 0.57 times (0 ~ 1 times). To pelvic mass, constipation, menstrual disorders and irregular vaginal bleeding as the main clinical manifestations. Gynecological check Annex area palpable solid or cystic solid mass. CA125 mild increase in 2 cases, CA199 increased in 1 case. Detection of neuroendocrine markers contribute to the diagnosis. Pathological examination confirmed that all 7 patients were stage Ⅰ, 3 had simple carcinoid, 3 had carcinoid teratoma and 2 had goiter. All the 7 patients underwent surgical treatment, including 4 cases of reproductive function and 3 cases of uterus and double attachment resection. One patient underwent BEP regimen (cisplatin, bleomycin, etoposide) 3 courses of chemotherapy and 1 course of chemotherapy of paclitaxel alone after 1 course of treatment. Regular follow-up, in addition to a lost case, no recurrence of cases. Conclusions The primary ovarian carcinoid tumors have lower malignant degree, better biological behavior, less distant metastasis and good early prognosis. However, this tumor may have a long-term recurrence, it should be long-term follow-up.