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交界性卵巢肿瘤:特征与争议点。

Borderline ovarian tumors: features and controversial aspects.

机构信息

Department of Gynecologic, Obstetric and Reproduction Sciences, Second University of Naples, Naples, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2013 Mar;167(1):86-9. doi: 10.1016/j.ejogrb.2012.11.002. Epub 2012 Dec 5.

Abstract

OBJECTIVE

To investigate features and controversial aspects of the borderline ovarian tumor (BOT), a neoplasm with favorable prognosis representing 10-15% of epithelial ovarian tumors.

STUDY DESIGN

: We retrospectively studied all patients treated at our institution from 2000 to 2010 taking into account the age, the stage, the type of surgery, the tumor size, the symptoms, the pre- and post-intervention tumor marker levels (CA125, CA19.9, CA15.3 and CEA), the presence of recurrence, the overall survival (OS), the progression-free survival (PFS).

RESULTS

A total of 43 patients were identified. The median age was 49 years (range: 15-82 years). The most frequent FIGO stage was IA (74% of the cases) with a prevalence of serous histotype, and 49% of the patients were asymptomatic. The CA125 level was abnormal in 55% of the patients before surgery, returning to the normal range in all cases after tumor removal. The PFS was 96% and 77% at five and sixty months respectively.

CONCLUSION

The BOT is closer to a benign than to a malignant tumor in the early stages, when confined to the ovary (IA and IB). In these stages conservative surgery is safe and advisable for women seeking offspring. In the other stages the need for a careful and long-term follow-up arises. CA125, despite its modest sensitivity and specificity, has a role in the follow-up of BOT.

摘要

目的

探讨交界性卵巢肿瘤(BOT)的特征和争议点。BOT 是一种预后良好的肿瘤,占上皮性卵巢肿瘤的 10-15%。

研究设计

我们回顾性研究了 2000 年至 2010 年在我院治疗的所有患者,考虑了年龄、分期、手术类型、肿瘤大小、症状、术前和术后肿瘤标志物水平(CA125、CA19.9、CA15.3 和 CEA)、复发情况、总生存期(OS)和无进展生存期(PFS)。

结果

共确定了 43 例患者。中位年龄为 49 岁(范围:15-82 岁)。最常见的 FIGO 分期为 IA(74%的病例),以浆液性组织类型为主,49%的患者无症状。55%的患者术前 CA125 水平异常,肿瘤切除后均恢复正常范围。PFS 分别为 96%和 77%,在 5 个月和 60 个月时。

结论

在早期局限于卵巢(IA 和 IB)时,BOT 更接近良性肿瘤而非恶性肿瘤。在这些阶段,对于寻求生育的女性来说,保留生育功能的手术是安全且可行的。在其他阶段,需要进行仔细和长期的随访。CA125 尽管敏感性和特异性不高,但在 BOT 的随访中具有一定作用。

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