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ID:27215634
大小:1.17 MB
页数:35页
时间:2018-12-02
《51例伴不同浸润程度卵巢交界性肿瘤临床病理分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、-------华中科技大学硕士学位论文diameteroftumorswere10.4cm,11.4cmand14.7cm,andthemediumvolumeswere394.21ml,540.3mland1084.3ml;25%,7/8and78.9%oftumorsdisplayedrichbloodflow.54.2%,4/8and78.9%ofpatientshadabnormaltumormarkers.Forserousborderlinetumorsandendometrialborderli
2、netumors,themediumCA-125were44.2U/ml,33.1U/ml,189.6U/ml.Allpatientsreceivedoperation;FIGOstageIwere41.7%,6/8and57.9%;41.7%,5/8and36.8%receivedconservativeoperation;41.7%,1/8and26.3%hadrestagingproceduresand5/10,0/1,2/5ofthemwereupstaged.21,6,19patientshadpe
3、lviclymphnodedissectionwithorwithoutpara-aorticlymphnodedissection,38.1%,1/6,5.2%werelymphnodepositive.Theaccuracyoffrozensectionwas54.3%,thesensitivitywas90.4%andthepositivepredictivevaluewas61.2%;noneoftheBOT-LGEOCwerediagnosedduringoperations.Positiverat
4、eofVEGFwere42.8%,4/7and50%.45.8%,7/8and89.4%ofpatientshadchemotherapy.For22caseswhoreceivedconservativeoperations,3caseshadshortermenstrualcyclesafterwards.For10patientswhohadfamilyplans,threepatientshadfivepregnanciesandthreefull-termdeliveries.Twopatients
5、recurred.Conclusions:BOTisconsistedofacontinuumofdiseases.MakingaccuratediagnosisofBOT-LGEOCisdifficultduringoperations.Forpatientswhohaveabnormaltumormarkersandsometypicalultrasoundmanifestations,adiagnosisofBOT-LGEOCcannotbeoverlooked.Thereisnodifferenceo
6、fexpressionofVEGFinBOTwithdifferentlevelsofinvasion.Forpatientswithfamilyplans,aconservativeoperationmightbeconsideredregardlessoftheirstages.Avoidanceofperformingcystectomymightlowerrecurrencerate.【Keywords】borderlineovariantumor;micro-invasion;micro-papil
7、lary;VascularEndothelialGrowthFactor,VEGF4-----------华中科技大学硕士学位论文前言卵巢交界性肿瘤(borderlineovariantumor,BOT)的概念最早来自1929年Taylor基于纽约医院卵巢肿瘤临床经验所做的观察性报道[1],他注意到某些上皮性肿瘤,即使腹腔内已广泛播散,其临床行为仍呈良性,与其他发生播散后迅速致死的上皮性癌明显不同,并将其命名为“一半恶性”(semi-malignant)。长期以来对BOT的命名及病理诊断标准一直存在不同的意见
8、,对其治疗更是存在较多争议。在上世纪70[2]和WHO[3]相继制定出BOT的诊断标准,将 年代早期,国际妇产科联盟(FIGO)其定义为“具有某些恶性肿瘤的形态学特点,但无破坏性的间质浸润”。经过30余年的探索,对其本质认识逐步深入,特别是2003年8月在美国马里兰州贝塞斯达举行[4],就BOT的某些病理学方面的分歧取得了较一致的意见。既往 的BOT工作会议观点认为BOT是一类同质性(homogen
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