国际生殖健康/计划生育 ›› 2015, Vol. 34 ›› Issue (6): 514-518.

• 综述 • 上一篇    下一篇

交界性卵巢肿瘤保留生育功能治疗研究进展

李抒畅,卢美松   

  1. 150006 哈尔滨医科大学第一临床医学院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-11-15 发布日期:2015-11-15
  • 通讯作者: 卢美松

Research Progress of Fertility Preservation Treatment in Patients with Borderline Ovarian Tumors

LI Shu-chang,LU Mei-song   

  1. The First Affiliated Hospital of Harbin Medical University, Harbin 150006, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-11-15 Online:2015-11-15
  • Contact: LU Mei-song

摘要: 交界性卵巢肿瘤是一类组织学特性和生物学行为介于良、恶性之间的卵巢肿瘤。交界性卵巢肿瘤患者发病年龄较轻,有年轻化趋势,其中约1/3 为未生育的年轻患者。由于交界性卵巢肿瘤病理学及临床较独特,在诊断和治疗上具有不同于卵巢癌的特点。保留生育功能的手术是年轻的交界性卵巢肿瘤患者的最佳治疗手段。行保守性手术相对安全, 再妊娠成功率高, 虽然保守性手术治疗卵巢交界性肿瘤的术后复发率高于非保守性手术, 但并未增加患者肿瘤复发的死亡率, 具体术式的选择应根据患者情况个体化综合考虑。化疗不推荐作为常规治疗。保留生育功能手术后妊娠对病程影响较小,也很少发生妊娠并发症。卵巢交界性肿瘤患者行保留生育功能手术安全可行,术后进行辅助生殖技术可改善妊娠结局,妊娠率可观。早期交界性卵巢肿瘤患者术后不孕可给予促排卵药物治疗,但晚期患者则需要谨慎对待。再分期手术和复发后手术应视具体情况进行。

关键词: 卵巢肿瘤, 生育力, 临床方案, 妊娠结局, 生殖技术, 辅助, 交界性肿瘤

Abstract: Borderline ovarian tumors(BOTs) are characterized by the histopathologic feature and biologic behavior which intermediate between clearly benign and frankly malignant ovarian tumors. The patients are young women, with a trend of younger, one-third of them have not completed childbearing. Because of BOTs′ unique pathological and clinical characteristics, the diagnosis and management of BOTs are different from those of ovarian cancer. For those young patients with BOTs, the fertility preservation surgery is the best option. This conservative surgery is still relatively safe, because the success rate of fertility is higher and the mortality of BOTs recurrence of conservative surgery is not increased although the recurrence rate is higher than that of non-conservative surgery. The detailed surgical option should be based on the individual circumstance. Chemotherapy should not be recommended as a routine. The complications followed by pregnancy are few,and pregnancy seems to have little impact on disease progression. The assisted reproductive technology can improve the pregnancy outcome in those BOTs patients after fertility preservation operation. The ovulation induction can be used in those patients with early-stage BOTs after fertility preservation operation, however it should be carefully used in those patients with advanced-stage BOTs.

Key words: Ovarian neoplasms, Fertility, Clinical protocols, Pregnancy outcome, Reproductive techniques, assisted, Borderline tumor