| 摘要: |
| 目的 分析卵巢恶性生殖细胞肿瘤（MOGCTs）患者行保留生育功能手术及化疗后的预后及妊娠生育情况。 方法 回 顾性分析 2003 年 1 月至 2010 年 12 月行保留生育功能手术的 31 例 MOGCTs 患者的临床病理资料及随访资料。 结果 31 例患者均 接受保留生育功能手术，术后接受了 1~6 个疗程辅助化疗，共随访 45~132 个月，中位随访时间 96 个月，2 例患者失访，3 例死亡，5 年累 积生存率为 83.6%。25 例停经患者中 22 例化疗后 6 个月内月经复潮，3 例 ６ 个月后月经复潮。2 例患儿发病时尚无初潮，化疗结束后未 影响月经初潮。停经患者停经期间血清黄体生成素（LH）升高至（61.8±11.3）mU/ml，促卵泡激素（FSH）明显升高至（89.7±40.2）mU/ml， 雌二醇（E2）水平降至（57.3±21.4）pg/ml，月经恢复后则恢复至正常水平，停经期间与月经复潮后比较均有统计学差异（均 P＜0.05）。患者 妊娠 9 例，其中 7 例足月自然或剖宫产分娩，无一例发生早产或胎儿畸形；不孕症 6 例，7 例随访结束尚未婚，另 4 例已婚但目前无生育计 划。 结论 行保留生育功能手术的 MOGCTs 患者总体预后良好，化疗对患者月经的影响是可逆的，妊娠率有待进一步提高。 |
| 关键词: 卵巢肿瘤 肿瘤 生殖细胞和胚胎 保留生育功能手术 预后 妊娠 |
| DOI： |
| 分类号: |
| 基金项目:浙江省医药卫生科技项目 |
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| Fertility-sparing surgery for malignant ovarian germ cell tumors |
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ZHANG Yingli, CHEN Lu, ZHU jianqin, YANG Zhengyan
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Zhejiang Cancer Hospital
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| Abstract: |
| Objective To evaluate the clinical outcomes of patients with malignant ovarian germ cell tumors (MOGCTs) undergoing fertility-sparing surgery. Methods Totally 31 MOGCTs patients underwent fertility-sparing surgery in our hospital between January 2003 and December 2010. The clinical-pathological and follow-up data were retrospectively analyzed. Results All these 31 MOGCTs patients received fertility-sparing surgery followed by 1~6 courses of BEP/BVP/TP chemotherapy. Patients were followed-up for 45~132 months after surgery with a mean follow-up time of 96 months; 2 patients were lost to follow-up and 3 died of the disease. The five-year cumulative survival rate was 83.6% . Among 25 patients with chemotherapy-related amenorrhea, 22 resumed menstruation within 6 months after chemotherapy and 3 after 6 months; while menstruation was not affected in 2 patients, who got the disease during childhood. During the amenorrhea period of patients, the serum LH and FSH levels rose to(61.8±11.3)mU/ml and(89.7±40.2)mU/ml, respectively(P＜0.05), and E2 level decreased to(57.3±21.4)pg/ml(P＜0.05); then returned to normal levels after menstruation recovery. Among these patients, 9 had pregnancies, 7 of whom delivered healthy babies; 6 were infertility, 7 were unmarried, and other 4 patients were married but had no desire of pregnancy. Conclusion Fertility-sparing surgery followed by adjuvant chemotherapy can achieve satisfactory effectiveness for MOGCTs. The effect of chemotherapy on menstruation is reversible and the pregnancy rate should be increased in the future. |
| Key words: Ovarian neoplasms Neoplasms Germ cell and embryonal Fertility-sparing surgery Prognosis Pregnancy |
