50岁以上女性卵巢小囊性肿瘤的恶性潜能。

The malignant potential of small cystic ovarian tumors in women over 50 years of age.

作者信息

Bailey C L, Ueland F R, Land G L, DePriest P D, Gallion H H, Kryscio R J, van Nagell J R

机构信息

Department of Obstetrics and Gynecology, University of Kentucky Medical Center, Lexington 40536, USA.

出版信息

Gynecol Oncol. 1998 Apr;69(1):3-7. doi: 10.1006/gyno.1998.4965.

DOI:10.1006/gyno.1998.4965

PMID:9570990

Abstract

OBJECTIVE

The aim of this study was to determine the risk of malignancy in cystic ovarian tumors < 10 cm in diameter in asymptomatic postmenopausal women or women >or =50 years of age.

METHODS

All cystic ovarian tumors detected by transvaginal sonography screening in asymptomatic postmenopausal women or women > or =50 years of age were evaluated with respect to size and morphology. Histology was recorded on all tumors removed surgically. Follow-up data were available both on patients undergoing surgery and on those who elected to be followed without operative intervention.

RESULTS

Unilocular cystic tumors were detected in 256 of 7705 patients (3.3%). All tumors were < 10 cm in diameter and 90% were < 5 cm in diameter. One hundred twenty-five of these cysts (49%) resolved spontaneously within 60 days and 131 (51%) persisted. Forty-five patients with persisting ovarian cysts underwent operative removal of these tumors. Thirty-two patients had ovarian serous cystadenomas, and the remainder had a variety of benign lesions. There were no cases of ovarian carcinoma in this group. Eighty-six patients with unilocular cystic ovarian tumors were followed at 3- to 6-month intervals without surgery, and none have developed ovarian cancer. Complex cystic ovarian tumors were detected in 250 patients (3.2%). All tumors were < 10 cm in diameter and 89% were < 5 cm in diameter. One hundred thirty-five (55%) resolved spontaneously within 60 days, and 115 (45%) persisted. One hundred fourteen of these patients underwent operative tumor removal. Seven patients had ovarian carcinoma, 1 had primary peritoneal cancer, and 1 had metastatic breast cancer to the ovary.

CONCLUSION

Unilocular ovarian cysts < 10 cm in diameter in asymptomatic postmenopausal women or women > or =50 years of age are associated with minimal risk for ovarian cancer. In contrast, complex ovarian cysts with wall abnormalities or solid areas are associated with a significant risk for malignancy. These data are important in determining optimal strategies for operative intervention in these patients.

摘要

目的

本研究旨在确定直径小于10cm的卵巢囊性肿瘤在无症状绝经后妇女或年龄大于或等于50岁的妇女中发生恶性病变的风险。

方法

对无症状绝经后妇女或年龄大于或等于50岁的妇女经阴道超声筛查发现的所有卵巢囊性肿瘤进行大小和形态评估。记录所有手术切除肿瘤的组织学情况。对接受手术的患者以及选择不进行手术干预而接受随访的患者均有随访数据。

结果

7705例患者中有256例（3.3%）检测到单房性囊性肿瘤。所有肿瘤直径均小于10cm，90%直径小于5cm。其中125个囊肿（49%）在60天内自发消退，131个（51%）持续存在。45例卵巢囊肿持续存在的患者接受了手术切除这些肿瘤。32例患者患有卵巢浆液性囊腺瘤，其余患者有各种良性病变。该组中无卵巢癌病例。86例单房性卵巢囊性肿瘤患者未手术，每隔3至6个月进行随访，均未发生卵巢癌。250例患者（3.2%）检测到复杂性卵巢囊性肿瘤。所有肿瘤直径均小于10cm，89%直径小于5cm。135个（55%）在60天内自发消退，115个（45%）持续存在。其中114例患者接受了手术切除肿瘤。7例患者患有卵巢癌，1例患有原发性腹膜癌，1例患有卵巢转移性乳腺癌。