首页|妊娠合并卵巢恶性肿瘤的临床分析

妊娠合并卵巢恶性肿瘤的临床分析

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目的:探讨妊娠合并卵巢恶性肿瘤患者的临床特点、治疗方案及妊娠结局.方法:回顾性分析 2012年 1月至 2022年 12月在广州医科大学附属第三医院就诊的 11例妊娠合并卵巢恶性肿瘤患者的病理类型、临床分期、手术方式、妊娠结局、随访结果等临床资料.结果:11例患者随访至 2023年 10月,其中卵巢原发肿瘤 6例,卵巢转移性肿瘤 5例.6例卵巢原发肿瘤中,上皮性肿瘤5例(ⅠA期 1例,ⅠC期 2例,ⅢA期 1例,ⅢB期 1例),恶性生殖细胞肿瘤 1例(ⅠA期);Ⅰ期 4例,孕早期发现 1例,要求继续妊娠,分娩后行分期手术,孕晚期发现 3例,剖宫产同时或产后行分期手术;Ⅲ期 2例,孕早期发现 1例,终止妊娠后行分期手术,孕晚期发现 1例,剖宫产同时行分期手术;5例成功分娩,早产 2例,足月产 3例,新生儿均健在;随访时间为 18~133个月,均生存.卵巢转移性肿瘤 5例,其中卵巢Krukerberg瘤 4例,子宫颈癌卵巢转移 1例;孕早期发现 2例,均终止妊娠后行减瘤术;孕中期发现 1例,要求继续妊娠,分娩后行减瘤术;孕晚期发现 2例,剖宫产同时行卵巢肿物手术 1例,产后行减瘤术 1例;成功分娩3例,均为早产,均健在;失访 1例,余 4例随访时间为 3~22个月,均死亡.结论:妊娠合并卵巢原发肿瘤预后较好,而妊娠合并卵巢转移性肿瘤恶性程度高、预后差,临床应引起重视.
Clinical analysis of pregnancy complicated with malignant ovarian tumors
Objective:To explore the clinical characteristics,treatments,and pregnancy outcomes of pregnant women with malignant ovari-an tumors.Methods:We retrospectively analyzed the clinical data of 11 patients with pregnancies complicated by malignant ovarian tu-mors,including the pathological types,clinical staging,surgical methods,pregnancy outcomes,and follow-up results from January 2012 to December 2022.Results:Among the eleven patients followed up until October 2023,six had primary ovarian tumors and five had metastat-ic ovarian tumors.Among the six primary ovarian tumors,five were epithelial tumors(one in stage ⅠA,two in stage ⅠC,one in stage ⅢA,one in stage ⅡB)and one was a malignant germ cell tumor(stage ⅠA).Four patients were diagnosed at stage Ⅰ:one in early pregnancy who continued the pregnancy and underwent tumor surgery post-delivery,and three in late pregnancy who under went tumor surgery dur-ing cesarean section or postpartum.Two patients were diagnosed at stage Ⅲ:one in early pregnancy with surgery after the termination of pregnancy,and one in late pregnancy with surgery during a cesarean section.Five patients had successful births,including two premature and three full-term births,all alive and healthy.The six patients with primary ovarian tumors were followed up for 18-133 months,and all survived.Five patients had ovarian metastatic tumors,including four cases of Krukenberg tumors and one of a cervical tumor.Two patients were diagnosed in the first trimester and underwent tumor reduction post-abortion.One patient was diagnosed in the second trimester,had to continue the pregnancy,and underwent tumor reduction post-delivery.Two patients were diagnosed in the third trimester:one under-went cesarean section and ovarian tumor resection simultaneously,and the other underwent tumor resection post-delivery.Three patients had successful births,all premature but alive.One of the five patients with ovarian metastatic tumors was lost to follow-up;the remaining four were followed up for 3-22 months,and all deceased.Conclusions:The prognosis for patients with pregnancies complicated by ovarian primary tumors is favorable,whereas the prognosis for patients with pregnancies complicated by ovarian metastatic tumors is poor,neces-sitating greater clinical attention.

gestation periodovarian malignancyclinical characteristicstreatment

汪志辉、林晓玲、吴晓健、胡勤斐、生秀杰

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广州医科大学附属第三医院妇科,广东省产科重大疾病重点实验室,广东省妇产疾病临床医学研究中心,粤港澳母胎医学高校联合实验室(广州市 510150)

妊娠期 卵巢恶性肿瘤 临床特点 治疗

广州市一般引导项目

20231A011095

2024

中国肿瘤临床
中国抗癌协会

中国肿瘤临床

CSTPCD北大核心
影响因子:1.32
ISSN:1000-8179
年,卷(期):2024.51(10)
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