| Purpose:To investigate the clinical data,pathological features,treatment and prognosis of Immature teratoma of ovary(OIT)and Peritoneal Glioma(GP),and to compare the differences between them.Methods:The clinical data of 42 patients with immature teratoma of ovary with or without gliomatosis who were pathologically diagnosed in the First Affiliated Hospital of Nanchang University from June 1,2011 to June 31,2021 were retrospectively analyzed.Results:Among the 42 patients with OIT and OIT combined with GP,37 patients with OIT(88.1%)and 5 patients with OIT combined with GP(11.9%)were OIT combined with GP.The mean age of onset in the two groups was 21.93 years old and 18.30 years old,respectively,and there was no significant difference in age between the two groups(P=0.534).The mean maximum tumor diameter of the two groups was14.60 cm and 24.60 cm,respectively,and there was significant statistical difference between the two groups(P=0.004).There were 41 cases(97.6%)with unilateral ovarian lesions,and only 1 case(2.4%)suggested simple OIT in both cases.Among41 cases with unilateral ovarian disease,7 cases(17.1%)were complicated with contralateral mature teratoma.23 cases(56.1%)had lesions on the right side and 18cases(43.9%)had lesions on the left side.Among the 5 patients with OIT combined with GP,2 patients with right OIT and 3 patients with left OIT showed no significant difference in tumor location between OIT and OIT combined with GP(P=0.429).The mean value of serum tumor marker CA125 in PATIENTS with OIT and OIT combined with GP was 60.75U/ m L and 281.86U/ m L,respectively,with significant statistical difference(P < 0.05).The mean CA199 values of the two groups were51.11 U/ m L and 245.83 U/ m L,respectively,with significant statistical difference(P<0.05).The average AFP of the two groups was 143.82ng/ m L and 191.18ng/ m L,respectively,with no statistical difference(P=0.734).There was no statistical difference in the positive rates of tumor markers CA125,CA199 and AFP between OIT and OIT combined with GP(P>0.05).31 cases(73.8%)were found to have complete tumor capsule,all of which were simple OIT.The tumor envelope was incomplete in 11 cases(26.2%),including all OIT combined with GP,and there was a statistical difference in tumor integrity between OIT and OIT combined with GP(P=0.001).According to the International Federation of Gynecology and Obstetrics(FIGO),35 cases(83.3%)were stage I(32 cases were stage IA,1 case was stage IB,2 cases were stage IC),all of which were simple OIT.6 patients(14.3%)had stage IIB,5 patients had OIT combined with GP;Stage III: 1 case(2.4%).There were 22cases(52.4%)in the organization grade I,all of which were simple OIT.There were15 cases(35.7%)of grade II,including 2 cases of OIT combined with GP.There were5 cases of grade III(11.9%),and 3 cases of OIT combined with GP.Among 42 OIT patients,20 cases(57.1%)underwent unilateral ovarian cyst stripping,15 cases(42.9%)underwent ipsilateral ovarian salpingectomy,including 1 case of OIT combined with GP.Seven patients(16.7%)received Comprehensive Staging Surgery(CSS)without preserving fertility function,and 3 of them were OIT combined with GP.Age(P=0.325),maximum tumor diameter(P=0.635),postoperative adjuvant chemotherapy(P=0.156)and whether combined with GP(P=0.055)had no significant difference in the three surgical methods of CSS without preserving fertility function,unilateral oophorectomy and ovarian cyst stripping.Tumor tissue grade(P=0.005),tumor integrity(P=0.001)and tumor FIGO stage(P=0.001)had statistically significant differences among the three surgical methods.None of the 42 patients was lost to follow-up,and there was only one stage III death during the follow-up period.The total follow-up time was 6-120(59.8 ±33.8)months.There was statistically significant difference in median PFS of PATIENTS with FIGO stage I to II(P=0.001).There were statistically significant differences in median PFS of tumor tissue grade(P=0.040),tumor tissue integrity(P=0.033)and whether GP was combined or not(P<0.001).There was no significant difference in the median PFS of stage I～II patients with three surgical methods(P=0.587)and whether chemotherapy was used after surgery(P= 0.796).Conclusions:1.FIGO stage and tumor tissue grade were independent risk factors affecting the prognosis of OIT,while combined GP had no significant effect on the prognosis.2.The completeness of tumor tissue and the maximum diameter of tumor were significantly correlated with OIT combined with GP,suggesting that it may be closely related to the occurrence of glioma.3.The level of OIT combined with GP was higher than that of SERUM tumor markers CA125 and CA199 of OIT alone.Therefore,when considering the diagnosis of OIT,the higher the level of CA125 and CA199,the higher the possibility of OIT combined with GP.4.For patients with stage I-II OIT and OIT combined with GP,no matter the grade of tumor tissue,because GP is mostly mature glial nodules,comprehensive staging surgery with fertility preservation can be adopted.Chemotherapy is not allowed after surgery,but strict follow-up monitoring is required. |
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