Analyse The Clinicopathologic Characteristics, Diagnosis And Treatment Of Adolescent Ovarian Tumors

Background and ObjectiveOvarian tumor is one of the most common malignant tumor of gynecological, there is high incidence of the women at reproductive age and postmenopausal age. Due to lack of specific methods for early diagnosis, resistance to chemotherapy and high recurrence rate, the mortality of ovarian cancer ranks first in gynecological malignancies. WTO requirement adolescents are the girls of 10 to 19 years old, the incidence of adolescent ovarian tumors is relatively low, but higher rate of the vicious than adult tumor, and has its own specialty and complexity pathological type and clinical treatment compared with adults. Because of few regular physical examination of adolescent girls, lack of specific early clinical manifestations, combined with the special nature of the age of puberty, the treatment of adolescent ovarian cancer is often overlooked, misdiagnosed. Young people are at an important stage of develop-ment of secondary sexual characteristics, correctly and timely to make diagnosis and treatment of the adolescent patients with ovarian tumor, are particularly important for patients to retain ovarian function, reproductive function, reduce complications and improve quality of life. Therefore, analysis of the incidence of ovarian tumors of this phase and to explore the rational treatment strategies has a special significance. To retrospectively analyze and summary medical records of 148 cases of adolescent ova- rian tumor in our hospital, discuss the clinicopathologic characteristics of the adolesc-ent ovarian tumor to guide clinical treatment.Materials and Methods1.148 cases of patients (10 to 19 years old) with ovarian tumor ofour hospital from January 2000 to December 2007, all patients confirmed the pathology diagnosis after operation in our hospital, all patients with no complications,and the informa-tion of patients is complete.2. To retrospectively analyze and summary medical records age, menstrual periods, symptoms, upplementary examination results, surgical procedures, the results of frozen section, after routine pathological findings, postoperative treatment con-ditions. Followed-up patients by telephone or examination of patients in out pati-ent.3. The data were analyzed by statistics software SPSS 17.0, Multi-samples rate comparison used contingency table chi-square test, survival rate was calculated by Kaplan-Meier. The test standard was a=0.05,P<0.05 statistically significant.Results1. The most common symptoms of adolescent ovarian tumors were:(1) abdominal pain(73/148,49.32%); (2) abdominal distension, abdominal mass(45/148,30.41 %); (3) irregular menstruation(22/148,14.86%).2. Benign ovarian tumor occupied 121 cases(81.76%), borderline ovarian tumor occupied 3 cases(2.03%), malignant ovarian tumor occupied 24 cases(16.22%). Histological classification:germ cell tumors occupied 71 cases(47.97%), tumor-like lesions occupied 39 cases(26.35%), epithelial tumors occupied 32 cases (21.62%), sex cord stromal tumor occupied 6 cases(4.05%). Mature cystic tera toma has the highest rate occupied 80.28%(57/71), mucinous epithelial tumor was the most histological type of epithelial tumor occupied 53.13%(17/32).3. The rate of ovarian tumor was 10.14%(15/148) before menarche, much more than the rate of ovarian cancer after menarche which was 89.86%(133/148). The rate of ovarian cancer was 33.33%(5/15) before menarche, the rate of ovarian cancer was 14.29%(19/133) after menarche, the difference between these tow rows was statistically significant(X2=4.120, P=0.042).4. The ultrasound had the accurate rate of 89.67%(78/87) in preoperative estimantio-n that the tumor was benign or malignant. The CT had the accurate rate of 92.86%(13/14) in preoperative estimantion that the tumor was benign or malign-ant.5. The emergency of adolescent ovarian tumor was 35.14%(52/148):42 patients was combined torsion, combined with tumor rupture in 8 cases,2 cases of malignant ovarian tumors.Torsion in 42 cases,39 cases of benign and malignant tumor in 3 cases. With the most common histological type of the tumor combined with torsion was mature cystic teratoma ccounting for 76.19%(32/42).6. The rate of misdiagnosis of adolescent ovarian tumors was 20.95%(31/148), adolescent ovarian tumors were often misdiagnosed as appendicitis, urinary stones, gastroenteritis, pelvic inflammatory disease, menstrual disorders, tuberc-ulosis, ectopic pregnancy.7.121 cases of adolescent benign ovarian tumors were given ovarian cystectomy or oophorectomy, followed up the patients 3 to 10 years,23 patients were lost followed, the prognosis was good.3 cases of borderline ovarian tumors:2 cases were followed up without recurrence; a routine ovarian cystectomy, recurrence 1 year after operation, surgical removal of the affected side line,and 3 patients were not given additional chemotherapy after peration.24 cases of malignant ovarian tumor:4 cases were given cytoreductive operation,20 cases to retain reproductive function, postoperative adjuvant chemotherapy. Patients were followed up 3 to 10 years,3 cases were lost followed,5-year survival rate of the patients with epithelial cancer was 64.50%,5-year survival of the patients with germ cell tumors was 81.49%, sex cord stromal tumors were without recurrence, The overall 5 year survival rate of adolescent ovarian cancer was 74.2% Conclusion1. There is a high rate of adolescent ovarian malignant tumor. a low incidence of the tumor, but a high rate of malignant before menarche.2. We should strengthen the healthy education and give physical examination to adolescent girls, use ultrasound, tumor markers and other means to improve the early diagnosis of ovarian tumors.3. We should both pay attention to the cure of cancer and retain reprouductive function when treat with adolescent ovarian tumor, establish individualized treatment scheme and strengthen the postoperative following.