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多学科诊疗对卵巢交界性肿瘤患者生育力的保护价值探讨

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目的 探讨多学科诊疗(multi-disciplinary team,MDT)对于卵巢交界性肿瘤(borderline ovarian tumor,BOT)患者的生育力保护价值.方法 将2020年1月—2022年12月在四川大学华西第二医院进行MDT的BOT患者作为MDT组,同时以1∶2的组织学类型比例挑选同期手术但未进行MDT的BOT患者作为对照组.回顾性分析两组的临床病例资料,比较两组患者的生育力评估情况、生育力保护措施实施情况以及生育结局.结果 MDT组共纳入患者24例,对照组共纳入患者48例.两组患者的发病年龄、婚姻状态、术前糖类抗原199、糖类抗原125、手术路径、国际妇产科联盟分期差异无统计学意义(P>0.05).MDT组第1次手术时肿瘤累及双侧的比例高于对照组(50.0%vs.22.9%,P<0.05).生育力评估情况方面,两组术前测定抗米勒管激素的患者比例差异无统计学意义(P>0.05),MDT组术后测定抗米勒管激素的患者比例高于对照组(100.0%vs.37.5%,P<0.05).MDT组采取生育力保护措施的患者比例高于对照组(62.5%vs.29.2%,P<0.05).两组患者中已婚者成功怀孕的比例差异无统计学意义(28.6%vs.25.9%,P>0.05).结论 MDT有利于提高育龄期BOT患者的生育力评估率,提供个体化治疗方案,及时采取措施保护患者的生育力.
Value exploration of multi-disciplinary team for fertility preservation in patients with borderline ovarian tumors
Objective To explore the value of multi-disciplinary team(MDT)for fertility preservation in patients with borderline ovarian tumor(BOT).Methods BOT patients who underwent MDT at West China Second University Hospital of Sichuan University between January 2020 and December 2022 were selected as the MDT group,while BOT patients who underwent surgery but did not undergo MDT during the same period were selected as the control group in a 1∶2 histological ratio.The clinical case data of two groups were retrospectively analyzed.The fertility assessment,implementation of fertility protection measures,and reproductive outcomes of two groups of patients were compared.Results A total of 24 patients were included in the MDT group,while 48 patients were included in the control group.There was no statistically significant difference in age of onset,marital status,preoperative carbohydrate antigen 199,carbohydrate antigen 125,surgical pathway,and International Federation of Gynecology and Obstetrics staging between the two groups of patients(P>0.05).The proportion of bilateral tumor involvement in the MDT group during the first surgery was higher than that in the control group(50.0%vs.22.9%,P<0.05).In terms of fertility assessment,there was no statistically significant difference in the proportion of patients who underwent preoperative measurement of anti-Mullerian hormone between the two groups(P>0.05).The proportion of patients who underwent postoperative measurement of anti-Müllerian hormone in the MDT group was higher than that in the control group(100.0%vs.37.5%,P<0.05).The proportion of patients in the MDT group who took fertility protection measures was higher than that in the control group(62.5%vs.29.2%,P<0.05).There was no statistically significant difference in the proportion of successful pregnancies between the two groups of patients who were married(28.6%vs.25.9%,P>0.05).Conclusion MDT is beneficial for improving the fertility assessment rate of BOT patients of childbearing age,providing personalized treatment plans,and taking timely measures to protect their fertility.

borderline ovarian tumormulti-disciplinary teamfertility protection

陈荞薇、林卫

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四川大学华西第二医院妇产科(成都 610041)

四川大学出生缺陷与相关妇儿疾病教育部重点实验室(成都 610041)

卵巢交界性肿瘤 多学科诊疗 生育力保护

2024

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子:0.744
ISSN:1002-0179
年,卷(期):2024.39(1)
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