| Background and ObjectiveOvarian Cancer during Pregnancy is one kind of cancer that is found or appears during pregnancy. European and American regions reported that incidence of cancer during pregnancy is1/15000-1/32000from1999to2000. Peking union medical college hospital summarizes the incidence of pregnancy with ovarian malignant tumor is0.75/10000in20years.In recent years the incidence of cancer during pregnancy significantly increased compared with the previous, after cervical cancer, On the one hand it may be related to the increased age of pregnant women and stimulate ovulation treatment. On the other hand spread of ultrasound during pregnancy and prenatal examination of department of gynaecology and cesarean delivery rates rise lead to found ovarian tumors during pregnancy and the cesarean section, Most of the patients with no different clinical manifestations, a few can cause bloating,abdominal pain and irregular vaginal abnormal drainage. Ultrasound use is helpful to find accessory mass in early pregnancy, but it is difficult to difference benign and malignant tumors. ultrasound use in middle-late pregnancy or cesarean section the rate is high. and found in relatively early clinical stages.Due to the particularity of the disease, its diagnosis and treatment are complex, Need to consider tumor pathological type and stage of differentiation, gestational weeks, maternal and fetal prognosis and willingness of individuals, and other factors. At home and abroad,it is still a lack of large sample multicenter randomized controlled trial to provide sufficient evidence of evidence-based medicine,In the clinical to diagnosis and treatment the disease mainly rely on the diagnosis and treatment of limited data and the personal experience of literature. This paper mainly analys the clinical data of cancer during pregnancy in patients, summarize the clinical characteristics, provide clinical experience to diagnosis and treatment of cancer during pregnancy.Methods1. Adopt the method of retrospective data analysis, To collect first affiliated hospital of zhengzhou university, the fifth affiliated hospital of zhengzhou university, zhengzhou central hospital affiliated to zhengzhou university three level of first-class hospital from January2001to December2010the clinical data of24patients who were merged pregnancy was diagnosed with cancer during pregnancy. review the surgical pathology slice, And according to the International Federation of Gynecobgy and Obsterics (FIGO) tumor staging standard2000to stage ovarian cancer. Pregnancy was found before merger ovarian cancer and received treatment or therapy has ended be ruled out.382363cases of patients with pregnancy. Cases of patients with data including age, maternal history, admitted to gestational age, treatment during pregnancy, pregnancy outcomes, operation method, pathological type and stage, whether chemotherapy, neonatal Apart score, prognosis of patients and so on, Through the retrospective investigation to collect the clinical data of patients, Follow-up by telephone or questionnaire for the prognosis of patients and children.2.Apply statistical software SPSS12.0to statistical analysis, Ratio analysis using Fisher test, P<0.05for statistical significance.Result1. Analysis the clinical dates of24patients of pregnancy with ovarian malignant tumors of first affiliated hospital of zhengzhou university, the fifth affiliated hospital of zhengzhou university, zhengzhou central hospital affiliated to zhengzhou university three level of first-class hospital from January2001to December2010. and382363pregnancy over the same period, The incidence is about0.6/10000.2. In24patients,5cases with abdominal distention and attendance;3patients with abdominal pain clinic;1case because of the blood in their stool visits;1case appeared irregular vaginal discharge;14patients without clinical symptoms,4cases in routine obstetric ultrasound examination,10cases found in the cesarean section.3. The epithelial ovarian tumor11cases, the epithelial ovarian tumor5cases Including phase â… ,â…¡,â…¢ and IV, respectively4,0,1,0cases; Border of ovarian tumors6cases were stage â… ; Ovarian germ cell tumors9cases of phase â… ,â…¡,â…¢ and â…£, respectively4,2,2,1case; Ovarian sex cord stromal tumor in2cases, all for phase â… ; Gastric metastasis to the ovary in2case, and colonic cancer metastasis to the ovary in1case.4. This group of24patients to keep reproductive function in10cases, including EOC1example, BOT7example, MGC1example, SCT1example, followed up for2years, patients with disease-free.4cases of pregnancy again,1case of BOT found tumor after3years and4months,in comprehensive stage surgery again, pathological back:ovarian serous cystadenocarcinoma.6patients with full staging surgery, including EOC3example, MGC3cases.4cases underwent preserving fertility function surgical, including BOT1cases, MGC2example, SCT1.1patients with cytoreductive surgery, as the EOC; Metastatic gastric carcinoma2cases, metastatic colon carcinoma in1case, laparotomy was all. Operation method is related to age, tumor type and whether to have the credits (P<0.05), has nothing to do with the pregnancy time (P>0.05).5. Of24cases of patients, there is no lpatient accepting chemotherapy during pregnancy, and14patients accepted chemotherapy after surgery, including EOC5cases, BOT2cases, MGC6cases, metastatic colon carcinoma1case. Chemotherapy regimens including PT solutions, PC solutions, PVB, BEP, CTX+cisplatin, The way to the medication is peritoneal perfusion or systemic intravenous injection method, the average period of treatment was4.7course.6.24cases of patients have complete follow-up data. Followed up for2years,19patients were survival,2-year overall survival rate is about79.17%,follow-up of 5years,15patients were survival,5-year survival rate is about62.5%. Of24cases of patients,3cases intrauterine pregnancy patients choose abortion,1foetal ded in4mid-pregnancy cases,2underwent amniocentesis,2cases give up baby of17late pregnancy patients, underwent amniocentesis;3cases premature babies, to promote lung maturity on cesarean section, neonatal premature birth rate was12.5%.Prognosis of patients is related to tumor pathological staging, type.have nothing to do with operation method,age, maternal time (P>0.05)Conclusion1. Use ultrasound examination or during cesarean section are likely to find the disease. And found in relatively early stage.2. The surgical programs should follow individual treatment according to specific circumstances. |
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