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目的分析卵巢恶性生殖细胞肿瘤(MOGCT)的临床特征与预后的关系。方法回顾性分析2004年1月-2009年1月该院收治的87例MOGCT患者的临床资料,并分析其临床特征与预后的关系。结果发病年龄6~62岁,平均(29.43±32.41)岁,中位发病年龄16.6岁,<30岁69例,占79.31%,≥30岁18例,占20.69%。肿瘤包块直径2.5~30 cm,平均15.4cm。56例采用保留生育功能的手术方式,31例未保留生育功能。肿瘤类型:无性细胞癌14例,占16.09%;未成熟畸胎瘤26例,占29.89%;绒毛膜癌2例,占2.30%;卵黄囊癌9例,占10.34%;混合型生殖细胞肿瘤33例,占37.93%;胚胎癌3例,占3.45%。手术病理分期:Ⅰ期41例,占47.13%;Ⅱ期14例,占16.09%;Ⅲ期26例,占29.89%;Ⅳ期6例,占6.90%。化疗情况:术后未进行化疗15例,化疗72例,其中61例接受BEP方案,7例因BEP方案耐受性差给予BVP方案,4例给予EMA-CO方案。化疗疗程<4月26例,≥4月35例。本研究87例MOGCT患者中2年内死亡10例,5年死亡21例。肿瘤类型、手术病理分期、残留病灶大小、有无化疗是影响MOGCT患者预后的决定性因素。结论 MOGCT患者临床表现复杂,但临床初治疗时应重视肿瘤类型、手术病理分期、肿瘤大小、腹水等因素,术中尽可能彻底清除病灶,术后尽量采用规范的化疗方案,改善患者预后。
Objective To analyze the relationship between the clinical features and the prognosis of ovarian malignant germ cell tumors (MOGCT). Methods The clinical data of 87 MOGCT patients admitted to our hospital from January 2004 to January 2009 were analyzed retrospectively. The relationship between the clinical features and the prognosis was analyzed. Results The age of onset was from 6 to 62 years (mean, 29.43 ± 32.41). The median age of onset was 16.6 years. There were 69 cases <30 years old, accounting for 79.31%, and 18 cases ≥ 30 years old, accounting for 20.69%. Tumor mass diameter 2.5 ~ 30 cm, an average of 15.4cm. Fifty-six cases were operated on with reproductive function, and 31 cases did not retain reproductive function. Tumor types: 14 cases of aneurysm cancer, accounting for 16.09%; 26 cases of immature teratoma, accounting for 29.89%; 2 cases of choriocarcinoma, accounting for 2.30%; yolk sac cancer in 9 cases, accounting for 10.34%; mixed germ cell tumors 33 cases, accounting for 37.93%; 3 cases of embryonic carcinoma, accounting for 3.45%. Pathological stage of surgery: stage Ⅰ 41 cases, accounting for 47.13%; stage Ⅱ 14 cases, accounting for 16.09%; stage Ⅲ 26 cases, accounting for 29.89%; stage Ⅳ 6 cases, accounting for 6.90%. Chemotherapy: Chemotherapy after operation in 15 cases, chemotherapy in 72 cases, of which 61 cases received BEP program, 7 cases of poor tolerability of BEP regimen given BVP program, 4 cases were given EMA-CO program. Chemotherapy <26 cases in April, ≥ April in 35 cases. In this study, 87 patients with MOGCT died in 10 cases within 2 years and 5 patients died in 21 cases. Tumor types, surgical pathology staging, residual tumor size, with or without chemotherapy is the decisive factor affecting the prognosis of patients with MOGCT. Conclusion The clinical manifestations of patients with MOGCT are complex. However, the initial clinical treatment should pay attention to the type of tumor, surgical pathology, tumor size, ascites and other factors, as far as possible the complete removal of the lesion surgery, postoperative standardized chemotherapy as far as possible to improve prognosis.