Liu J, Chu H J, Shan Y P, Song W J, Chen A P
Department of Obstetrics and Gynecology, the Affiliated Hospital of Qingdao University, Qingdao 266000, ChinaLiu Juan is working on the Department of Obstetrics and Gynecology, Qingdao Pingdu Maternal and Child Health Hospital, Qingdao 266700, China.
Zhonghua Fu Chan Ke Za Zhi. 2024 Mar 25;59(3):210-214. doi: 10.3760/cma.j.cn112141-20231121-00212.
To investigate the diagnosis, treatment and prognosis of ovarian yolk sac tumor (OYST). The clinicopathological data and follow-up data of 12 patients with OYST admitted to the Affiliated Hospital of Qingdao University from January 2013 to December 2020 were retrospectively analyzed, and the diagnosis, treatment and prognosis of OYST patients were summarized. (1) The age of 12 patients with OYST ranged from 11 to 37 years, with a median age of 20 years. At the first visit, all 12 patients had pelvic masses. Reasons for seeing a doctor: 6 cases of abdominal distension and abdominal pain, 4 cases of mass in the lower abdomen, 1 case of vaginal bleeding, and 1 case of appendicitis. International Federation of Obstetrics and Gynecology (FIGO) 2014 staging: 4 cases in stage Ⅰa, 2 cases in stage Ⅰc, 1 case in stage Ⅱc, 4 cases in stage Ⅲc, and 1 case in stage Ⅳb. (2) All 12 patients were examined by color Doppler ultrasound before operation, among which 10 cases showed unilateral adnexal masses and 2 cases bilateral adnexal masses. The median maximum diameter of tumor was 16.5 cm (range: 6.0-28.0 cm). The preoperative levels of alpha fetoprotein (AFP) in 12 patients (all >1 210 μg/L) were significantly higher than normal (<25 μg/L). Among the 11 patients with cancer antigen 125 (CA) detection results, 9 patients showed elevated serum CA levels. (3) Among the 12 patients, 8 young infertile patients who needed to preserve their reproductive function underwent appendectomy, 3 infertile patients underwent staged surgery for ovarian malignant germ cell tumor, and only one bilateral lesion and infertile patient underwent unsatisfactory staged surgery for ovarian malignant germ cell tumor. Of the 12 patients, 11 patients were given combined chemotherapy regimen of bleomycin, cisplatin, and etoposide (BEP) after operation. One patient without chemotherapy developed metastasis 3 months after operation, and was given BEP chemotherapy, and her condition was controlled. (4) The deadline for follow-up was December 31st, 2022, and the median follow-up time was 60 months (range: 25-115 months). All the 12 patients survived without tumor during the follow-up period, and the median disease-free survival time was 84.5 months (range: 25-115 months). OYST mostly occurs in children and young women. Color Doppler ultrasound examination and serum AFP and CA detection have diagnostic value for OYST. Surgical treatment after diagnosis of OYST includes surgery to preserve reproductive function and timely and standardized chemotherapy after operation. The prognosis of patients is good regardless of stage.
探讨卵巢卵黄囊瘤（OYST）的诊断、治疗及预后。回顾性分析2013年1月至2020年12月青岛大学附属医院收治的12例OYST患者的临床病理资料及随访资料，总结OYST患者的诊断、治疗及预后情况。（1）12例OYST患者年龄11～37岁，中位年龄20岁。初诊时12例患者均有盆腔肿块。就诊原因：腹胀腹痛6例，下腹部肿块4例，阴道流血1例，阑尾炎1例。国际妇产科联盟（FIGO）2014分期：Ⅰa期4例，Ⅰc期2例，Ⅱc期1例，Ⅲc期4例，Ⅳb期1例。（2）12例患者术前均行彩色多普勒超声检查，其中10例显示单侧附件区肿块，2例双侧附件区肿块。肿瘤最大径中位数为16.5 cm（范围：6.0～28.0 cm）。12例患者术前甲胎蛋白（AFP）水平（均>1 210 μg/L）均显著高于正常（<25 μg/L）。11例癌抗原125（CA）检测结果患者中，9例血清CA水平升高。（3）12例患者中，8例有生育要求的年轻不孕患者行保留生育功能手术，3例不孕患者行卵巢恶性生殖细胞肿瘤分期手术，仅1例双侧病变不孕患者行卵巢恶性生殖细胞肿瘤分期手术效果不理想。12例患者中，11例术后给予博来霉素、顺铂和依托泊苷（BEP）联合化疗方案。1例未化疗患者术后3个月出现转移，给予BEP化疗后病情得到控制。（4）随访截止至2022年12月31日，中位随访时间为60个月（范围：25～115个月）。12例患者随访期间均无瘤存活，无病生存时间中位数为84.5个月（范围：25～115个月）。OYST多发生于儿童及年轻女性。彩色多普勒超声检查及血清AFP、CA检测对OYST有诊断价值。OYST确诊后的手术治疗包括保留生育功能手术及术后及时规范化疗。患者无论分期预后均良好。
