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黏液性交界性卵巢肿瘤伴和不伴上皮内癌:临床病理特征和生育结果的差异。

Mucinous borderline ovarian tumors with and without Intraepithelial Carcinoma: Differences in clinicopathologic features and fertility results.

机构信息

Department of Gynecological Oncology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China.

Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People's Republic of China.

出版信息

J Obstet Gynaecol Res. 2020 Apr;46(4):646-653. doi: 10.1111/jog.14210. Epub 2020 Feb 11.

Abstract

AIM

To investigate the clinicopathologic characteristic and fertility results of patients with mucinous borderline ovarian tumors (MBOTs), and the effects of intraepithelial carcinoma (IECA) on them.

METHODS

Fifty-two patients treated for MBOTs with or without IECA were retrospectively analyzed.

RESULTS

Patients with IECA were more frequently observed at stage Ic (3/12 vs 1/40, P = 0.034) and accompanied by microinvasive carcinoma (3/12 vs 1/40, P = 0.034). The detected rate of IECA by intraoperative frozen section (5/12, 41.7%) was much lower than that of MBOTs (82.5%, P = 0.010). About 61.5% patients in our study underwent fertility-sparing surgery. Follow-up information was retained completely in 41 patients. And all four tumor recurrences were observed (9.8%) in conservative surgery group in 66 months, though there was no statistical association (P = 0.280). There were three patients who recurred more than once, even one occurred tumor-related death. Only one recurrent patient was in IECA group (P > 0.05). However, patients with IECA were more likely to receive adjuvant chemotherapy (3 of 12 vs 0 of 40, P = 0.010) and surgical staging (75% vs 52.5%, P = 0.200). As for fertility results, nine patients wished to be pregnant and seven of them (77.8%) were successful.

CONCLUSION

For young patients with MBOTs, fertility results are satisfactory after conservative surgery. But patients should be fully informed about the relative high recurrent rate. And IECA has no statistical negative effects on MBOTs till now, but a long-term follow-up is required.

摘要

目的

探讨黏液性交界性卵巢肿瘤(MBOT)患者的临床病理特征和生育结局,以及上皮内癌(IECA)对此的影响。

方法

回顾性分析了 52 例接受 MBOT 治疗的患者,其中包括合并或不合并 IECA 的患者。

结果

合并 IECA 的患者更常处于 Ic 期(3/12 比 1/40,P = 0.034),并伴有微浸润癌(3/12 比 1/40,P = 0.034)。术中冷冻切片检测到 IECA 的检出率(5/12,41.7%)明显低于 MBOTs(82.5%,P = 0.010)。本研究中约 61.5%的患者接受了保留生育功能的手术。在 41 例患者中保留了完整的随访信息。在 66 个月的随访中,保守手术组有 4 例(9.8%)肿瘤复发,但无统计学关联(P = 0.280)。有 3 例患者复发超过 1 次,甚至有 1 例发生肿瘤相关死亡。仅 1 例复发病例为 IECA 组(P > 0.05)。然而,合并 IECA 的患者更可能接受辅助化疗(3/12 比 0/40,P = 0.010)和手术分期(75%比 52.5%,P = 0.200)。至于生育结局,有 9 名患者希望怀孕,其中 7 名(77.8%)成功怀孕。

结论

对于年轻的 MBOT 患者,保守手术后的生育结局令人满意。但应充分告知患者相对较高的复发率。目前,IECA 对 MBOTs 没有统计学上的负面影响,但需要长期随访。

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