51例伴不同浸润程度卵巢交界性肿瘤临床病理分析-(7319)

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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.Forserousborderlinetumorsandendometrialborderlinetumors,themediumCA-125were44

2、.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.21,6,19patientshadpelviclymphnodedissectionwithorwithoutpara-aorticlymphn

3、odedissection,38.1%,1/6,5.2%werelymphnodepositive.Theaccuracyoffrozensectionwas54.3%,thesensitivitywas90.4%andthepositivepredictivevaluewas61.2%;noneoftheBOT-LGEOCwerediagnosedduringoperations.PositiverateofVEGFwere42.8%,4/7and50%.45.8%,7/8and89.4%ofpatientshadchemotherapy.For22c

4、aseswhoreceivedconservativeoperations,3caseshadshortermenstrualcyclesafterwards.For10patientswhohadfamilyplans,threepatientshadfivepregnanciesandthreefull-termdeliveries.Twopatientsrecurred.Conclusions：BOTisconsistedofacontinuumofdiseases.MakingaccuratediagnosisofBOT-LGEOCisdiffi

5、cultduringoperations.Forpatientswhohaveabnormaltumormarkersandsometypicalultrasoundmanifestations,adiagnosisofBOT-LGEOCcannotbeoverlooked.ThereisnodifferenceofexpressionofVEGFinBOTwithdifferentlevelsofinvasion.Forpatientswithfamilyplans,aconservativeoperationmightbeconsideredrega

6、rdlessoftheirstages.Avoidanceofperformingcystectomymightlowerrecurrencerate.【Keywords】borderlineovariantumor；micro-invasion；micro-papillary；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［1］基于纽约医院卵巢肿瘤临床经验所做的观察性报道，他注意到某些上皮性肿

7、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，对其治疗更是存在较多争议。在上世纪70［2］［3］年代早期，国际妇产科联盟（FIGO）和WHO相继制定出BOT的诊断标准，将其定义为“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］的BOT工作会议，就BOT的某些病理学方面的分歧取得了较一致的意见。既往观

8、点认为BOT是一类同质性（homogeneous）疾病，生物学行为均介于卵巢良、