Chao Xiaopei, Wang Xiaoxia, Xiao Yu, Ji Mingliang, Wang Shu, Shi Honghui, Fan Qingbo, Leng Jinhua, Sun Dawei, Lang Jinghe
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing.
Department of Gynecology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou City, Gansu Province.
Medicine (Baltimore). 2019 Oct;98(41):e17540. doi: 10.1097/MD.0000000000017540.
To analyze the clinicopathological characteristics of pelvic masses after hysterectomy for benign diseases, and to analyze the related factors of benign and malignant pelvic masses.This study retrospectively analyzed the patients undergone reoperation for pelvic mass subsequently to hysterectomy for benign disease from January 2012 to December 2016 in Peking Union Medical College Hospital.A total of 247 patients were enrolled in this study, of which 34.01% were diagnosed with malignant tumors, and 65.99% benign tumors. Comparing the clinicopathological data of patients with benign and malignant pelvic masses, significant differences were found between the 2 groups with regard to their ages of having hysterectomy and pelvic mass resection, and the time intervals between the onset of pelvic mass and hysterectomy. In addition, patients with malignant masses tended to complain of abdominal distension and abdominal pain, while most of those with benign masses were diagnosed during physical examination. Patients with malignant pelvic masses had medical imagines of mixed masses, extraovarian derivation, as well as elevated carbohydrate antigen-125 (CA 125). Multivariate analysis showed that ages of having hysterectomy, physical examination results, abnormal defecation, cystic and solid masses, and elevated CA 125 level were independent risk factors for benign and malignant pelvic masses.For patients having pelvic masses following hysterectomy for benign diseases, if they had hysterectomy later in their lives, and their masses were not found during physical examination, and had abnormal defecation, mixed cystic solid mass as well as elevated serum CA 125, it is suggested that special attention should be paid to the possibility of malignant tumors.
分析良性疾病子宫切除术后盆腔肿块的临床病理特征,以及分析盆腔良恶性肿块的相关因素。本研究回顾性分析了2012年1月至2016年12月在北京协和医院因良性疾病行子宫切除术后因盆腔肿块再次手术的患者。本研究共纳入247例患者,其中34.01%被诊断为恶性肿瘤,65.99%为良性肿瘤。比较盆腔良恶性肿块患者的临床病理资料,发现两组在子宫切除和盆腔肿块切除的年龄以及盆腔肿块发病与子宫切除的时间间隔方面存在显著差异。此外,恶性肿块患者倾向于主诉腹胀和腹痛,而大多数良性肿块患者是在体检时被诊断出来的。盆腔恶性肿块患者的医学影像表现为混合性肿块、卵巢外起源以及糖类抗原125(CA 125)升高。多因素分析表明,子宫切除年龄、体检结果、排便异常、囊实性肿块以及CA 125水平升高是盆腔良恶性肿块的独立危险因素。对于良性疾病子宫切除术后出现盆腔肿块的患者,如果其子宫切除年龄较大,肿块未在体检时发现,存在排便异常、囊实性混合肿块以及血清CA 125升高,建议应特别注意恶性肿瘤的可能性。