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浆液性卵巢交界性肿瘤患者中微乳头模式的预后意义。

Prognostic significance of the micropapillary pattern in patients with serous borderline ovarian tumors.

作者信息

Chang Suk-Joon, Ryu Hee-Sug, Chang Ki-Hong, Yoo Seung-Chul, Yoon Jong-Hyuck

机构信息

Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.

出版信息

Acta Obstet Gynecol Scand. 2008;87(4):476-81. doi: 10.1080/00016340801995640.

Abstract

BACKGROUND

The impact of micropapillary histology on survival in patients with serous borderline ovarian tumors is not established. The purpose of this study was to evaluate the significance and influence of micropapillary pattern on clinical outcome of patients with serous borderline ovarian tumors.

METHODS

Eighty-five patients who underwent surgery and were diagnosed with serous borderline ovarian tumors were retrospectively studied. Among these patients, 18 patients showed micropapillary pattern on histologic examination, while the remaining 67 patients did not. The significance of the presence of micropapillary pattern and relationship with various clinicopathologic findings and progression-free survival were evaluated by statistical analysis.

RESULTS

No differences with regard to age, parity, body mass index, pretreatment CA-125 level, tumor size, bilaterality, and the duration of follow-up were observed between the two groups, but there was a significant difference in terms of FIGO stage (p<0.001), invasive implants (p=0.004), performing lymphadenectomy (p=0.009), operation time (p=0.003), estimated blood loss (p<0.001), residual disease>1 cm (p=0.001), adjuvant chemotherapy (p<0.001), and the length of hospital stay (p=0.013). Progression-free survival was found to be significantly decreased in patients with invasive implants (HR, 5.06; p=0.025) and micropapillary pattern (HR, 4.20; p=0.056) on multivariate analysis.

CONCLUSIONS

Micropapillary serous borderline ovarian tumors were associated with a more aggressive clinical course compared with typical serous borderline ovarian tumor. The presence of invasive implants and micropapillary pattern were significant prognostic factors in patients with serous borderline ovarian tumors.

摘要

背景

微乳头组织学对浆液性卵巢交界性肿瘤患者生存的影响尚未明确。本研究旨在评估微乳头模式对浆液性卵巢交界性肿瘤患者临床结局的意义和影响。

方法

回顾性研究85例接受手术并被诊断为浆液性卵巢交界性肿瘤的患者。在这些患者中,18例在组织学检查中显示微乳头模式,其余67例未显示。通过统计分析评估微乳头模式的存在意义及其与各种临床病理特征和无进展生存期的关系。

结果

两组在年龄、孕次、体重指数、术前CA-125水平、肿瘤大小、双侧性及随访时间方面未观察到差异,但在国际妇产科联盟(FIGO)分期(p<0.001)、浸润性种植(p=0.004)、行淋巴结切除术(p=0.009)、手术时间(p=0.003)、估计失血量(p<0.001)、残留病灶>1 cm(p=0.001)、辅助化疗(p<0.001)及住院时间(p=0.013)方面存在显著差异。多因素分析发现,有浸润性种植(风险比[HR],5.06;p=0.025)和微乳头模式(HR,4.20;p=0.056)的患者无进展生存期显著缩短。

结论

与典型浆液性卵巢交界性肿瘤相比,微乳头浆液性卵巢交界性肿瘤的临床病程更具侵袭性。浸润性种植和微乳头模式的存在是浆液性卵巢交界性肿瘤患者的重要预后因素。

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