唐莉  叶旭彬  吴雪薇

[摘要] 目的 探讨年轻妇女卵巢上皮癌的临床特点、治疗、生存率及预后因素分析。 方法 回顾行分析1990年1月～2012年12月我院收治的62例年龄≤40岁的卵巢上皮癌患者的临床资料。生存率用寿命表法计算。利用Cox模型分析比较影响预后的因素。 结果 62例患者确诊为卵巢上皮癌中位年龄（31.3±1.6）岁。临床表现自扪及腹部包块或体检发现腹部包块17例、腹痛、腹胀各12例，肿物最大径线平均为（13.15±2.17）cm，57例可行满意细胞减灭术，手术病理分期Ⅰ期37例，占59.67%；Ⅱ期7例，占11.29%；Ⅲ期13例，占20.96%；Ⅳ期5例，占8.06%。病理分化程度以浆液性囊腺癌（35例，56.45%）和黏液性囊腺癌（18例，29.03%）为最多。病理分化程度高分化38例（61.2%）、中分化15例（24.2%）、低分化9例（14.5%）。59例术前或术后进行了以铂或紫杉醇类为基础的化疗。12例保守手术中（均为Ⅰa，G1期患者），10例无瘤生存（83.34%）。按寿命表法计算的3年生存率为86.7%，5年生存率为78.3%。结论 40岁以下妇女卵巢上皮性癌患者，肿瘤体积大，单侧多见，手术病理分期早，病理分化程度好，以浆液性囊腺癌多见，总的五年生存率高，预后好。部分Ⅰa、G1期患者可保留生育功能。病理分级、残留病灶大小是40岁以下妇女卵巢上皮癌的独立预后因素。

[关键词] 卵巢上皮癌；预后因素；年龄；生存率

[中图分类号] R737.3   [文献标识码] A   [文章编号] 2095-0616（2014）09-28-05

Clinical analysis of 62 women with epithelial ovarian cancer under age of 40 years

TANG Li  YE Xubin  WU Xuewei

Department of Gynecology and Obstetrics,Dongguan People's Hospital,Dongguan 523000,China

[Abstract] Objective To investigate the clinical characteristics, treatment, survival rate and prognosis factors of the young women with epithelial ovarian cancer. Methods Clinical data of 62 women with epithelial ovarian cancer under the age of 40 years treated in our hospital from January 1990 to December 2012 were analyzed retrospectively.The survival rate was calculated using the life table.The cox model was used to analyze and compare the factors influencing prognosis. Results Sixty-two patients diagnosed with epithelial ovarian cancer had a median age of (31.3±1.6) years. Physical examination found abdominal mass in 17 patients and stomachache and abdominal distension in 12 patients respectively.The average maximum radial line of lump was (13.15±2.17) cm.Fifty-seven patients could receive satisfaction cytoreductive surgery.Thirty-seven patients were in surgical pathological stage I,accounting for 59.67%,7 patients stage Ⅱ,accounting for 11.29%,13 patients stage Ⅲ,accounting for 20.96%,and 5 patients stage IV,accounting for 8.06%. Pathological differentiation degrees were mainly serous adenocarcinoma (35 patients,56.45%) and mucinous adenocarcinoma(18 patients,29.03%).In terms of pathological differentiation degree,38 patients(61.2%) were highly differentiated,15 patient (24.2%) were moderately differentiated and 9 patients (14.5%) were poorly differentiated.Fifty-nine patients received preoperative and postoperative chemotherapy based on platinum or taxanes.Of the 12 patients receiving conservative surgery(all patients were Ia and G1),10 patients survived without tumor(83.34%).The 3-year survival rate calculated based on the life table method was 86.7% and the 5-year survival rate was 78.3%. Conclusion For the women with epithelial ovarian cancer under the age of 40 years,the size of tumor is large,unilateral is mostly seen, surgical pathological staging is early, pathological differentiation degree is good,serous cystadenocarcinoma is mostly seen,the total 5-year survival rate is high,and the prognosis is good.Some patients of Ia and G1 can preserve fertility function. Pathological staging and size of residual lesion are the independent prognosis factors of women with epithelial ovarian cancer under the age of 40 years.

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[Key words] Epithelial ovarian cancer;Prognosis factor;Age;Survival rate

卵巢癌是女性生殖器常见恶性肿瘤，其死亡率高居妇科恶性肿瘤之首。近年来，卵巢恶性肿瘤的发病率呈逐年上升趋势。其中70%～80%为上皮癌。卵巢上皮性癌多发生于绝经期妇女，以晚期多

表1  病理类型FIGO分期细胞学分级

病理类型 总例……