Nardo Luciano G, Kroon Nicolette D, Reginald Philip W
Gynaecology Cancer Unit, Department of Obstetrics and Gynaecology, Wexham Park Hospital, Slough, Berkshire, United Kingdom.
Obstet Gynecol. 2003 Sep;102(3):589-93. doi: 10.1016/s0029-7844(03)00663-x.
At present it is not well known whether some persistent unilocular ovarian cysts can develop into malignancy. The aim of this observational study was to define the management of postmenopausal women with persistent unilocular ovarian cysts less than 50 mm in diameter and with normal serum CA 125 levels.
Retrospective data were obtained from 226 postmenopausal women (mean age 56.2 years, range 45-87) with unilocular ovarian cysts who were followed up for a 5-year period. Women were referred because of postmenopausal symptoms, abdominal discomfort, and postmenopausal bleeding. All women underwent pelvic examination, transvaginal ultrasonography, and serum CA 125 measurement. Tumor-associated antigen CA 125 and ovarian cyst diameter were assessed routinely. Surgery was offered according to clinical indications and women's wishes.
Ovarian cyst diameter and serum CA 125 levels did not change in 172 of 226 women (76.1%). Conversely, the remaining 54 women had an increase in cyst diameter, and six of those (11.1%) also had raised serum CA 125 levels. All women with suspicious ovarian pathology (n=54) and 84 without ovarian pathology underwent surgical management. International Federation of Gynecology and Obstetrics stage IB well-differentiated serous cystoadenocarcinomas were diagnosed in two of 54 women (3.7%). Serum CA 125 levels were elevated in both cases.
These findings suggest that the majority of unilocular ovarian cysts with diameter less than 50 mm are benign and remain unchanged. These lesions can be managed expectantly when there is no increase in the ovarian cyst diameter and the serum CA 125 concentration is normal.
目前尚不清楚一些持续性单房性卵巢囊肿是否会发展为恶性肿瘤。本观察性研究的目的是确定直径小于50mm且血清CA 125水平正常的绝经后妇女持续性单房性卵巢囊肿的管理方法。
回顾性收集了226例绝经后单房性卵巢囊肿妇女（平均年龄56.2岁，范围45 - 87岁）的资料，随访期为5年。这些妇女因绝经后症状、腹部不适和绝经后出血前来就诊。所有妇女均接受了盆腔检查、经阴道超声检查和血清CA 125检测。常规评估肿瘤相关抗原CA 125和卵巢囊肿直径。根据临床指征和患者意愿提供手术治疗。
226例妇女中有172例（76.1%）卵巢囊肿直径和血清CA 125水平未发生变化。相反，其余54例妇女囊肿直径增大，其中6例（11.1%）血清CA 125水平也升高。所有有可疑卵巢病变的妇女（n = 54）和84例无卵巢病变的妇女均接受了手术治疗。54例妇女中有2例（3.7%）被诊断为国际妇产科联盟（FIGO）分期为IB期的高分化浆液性囊腺癌。这两例患者血清CA 125水平均升高。
这些发现表明，大多数直径小于50mm的单房性卵巢囊肿是良性的，且保持不变。当卵巢囊肿直径无增加且血清CA 125浓度正常时，这些病变可进行观察处理。
