Gershenson David M
Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Unit 1362, 1155 Pressler Drive, Houston, TX 77030, USA.
Best Pract Res Clin Obstet Gynaecol. 2017 May;41:49-59. doi: 10.1016/j.bpobgyn.2016.09.012. Epub 2016 Oct 3.
Approximately 3000 American women are diagnosed with borderline ovarian tumours annually. Borderline tumours are similar to other types of adnexal masses. Prognostic factors include the International Federation of Gynecology and Obstetrics (FIGO) stage, presence of peritoneal implants, micropapillary pattern (for serous histology), microinvasion and intra-epithelial carcinoma (for mucinous histology). Approximately 65-70% of serous tumours and 90% of mucinous tumours are stage I, and 30% and 10%, respectively, are associated with extra-ovarian spread. Fertility-preservation counselling is recommended for young patients. Fertility-sparing surgery is feasible in a high proportion of women in the reproductive age group. Surgical staging generally includes resection of the primary borderline tumour, by either unilateral salpingo-oophorectomy or ovarian cystectomy, cytologic washings, omentectomy and peritoneal biopsies, and routine lymphadenectomy is not recommended. However, because the accuracy of frozen-section examination is lower than optimal, caution is recommended. Postoperative therapy is recommended only for those women with serous borderline tumours and invasive implants. Fortunately, relapse is uncommon.
每年约有3000名美国女性被诊断为卵巢交界性肿瘤。交界性肿瘤与其他类型的附件肿物相似。预后因素包括国际妇产科联盟（FIGO）分期、腹膜种植情况、微乳头模式（浆液性组织学类型）、微浸润以及上皮内癌（黏液性组织学类型）。浆液性肿瘤约65% - 70%为Ⅰ期，黏液性肿瘤约90%为Ⅰ期，分别有30%和10%与卵巢外播散有关。建议对年轻患者进行保留生育功能的咨询。对于育龄期女性，很大一部分可行保留生育功能的手术。手术分期一般包括通过单侧输卵管卵巢切除术或卵巢囊肿切除术切除原发性交界性肿瘤、细胞学冲洗、网膜切除术和腹膜活检，不建议常规进行淋巴结切除术。然而，由于冰冻切片检查的准确性低于最佳水平，建议谨慎操作。仅对患有浆液性交界性肿瘤和有浸润性种植的女性推荐术后治疗。幸运的是，复发并不常见。
