| Objective:Borderline ovarian tumors(BOT)is a ovarian surface epithelial interstitial tumors between benign and malignant , With low-grade malignant potential ,accompanied by a certain degree of nuclear not typical and epithelial hyperplasia ,Not with destructive interstitial infiltrates .BOT has nonspecific clinical manifestation, onset hidden, and preoperative diagnosis method nonspecific. Intraoperative frozen pathological help determine but eventually need postoperative paraffin pathology to clear diagnosis, so it's difficult to choose the surgical methods and scope. Initial treatment of BOT is used to refer to ovarian cancer ,but it become an independent clinical and pathological type since 1973.In recent years, with the nature of its organizational biology research, new suggestions is put forward In treatment. This paper summarizes BOT in clinical characteristics,pathological type,FIGO staging,treatment and prognosis,discuss the diagnosis and treatment.Methods: Make retrospective analysis with the information of 60 BOT patients in Dalian medical university subsidiary first hospital gynecological ward, using SPSS11.5 to establish database and analysis statistical.Result:1,60 BOT patients were 3.1% of the same ovarian tumor patients ,16.3% of ovarian malignant tumor,the average onset age is (42.7±19.4岁)(17—89),21 cases did not bear ,21 cases already postmenopausal,menopause from1 to 39 years。51 cases in stage I(85%),6 cases in stage II(10%),3 cases in stage III(5%),none in stage IV。42 cases is grout tumor(70%),5 cases bilateral onset,14 cases is mucinous tumor(23.3%),1 case bilateral onset,Mixed 3 cases (5%),Transparent cell 1 case(1.7%)。2,BOT patients were nonspecific clinical manifestation. Under much manifestation BOT pa cystic or pouch or solid (98.5%), mucus sex tumor hint has the room every or thickening between dense room, room , serum sex duodenum room, more inside contain nipple (82.5%), serum sex more mucinous tumor size small (P <0.05), in 43 cases of patients BOT nipple or substantial area can be detected, 20 cases of measuring blood flow impedance index (RI), an average of (0.54±0.21).3,Serum CA125 CA199 CEA in total positive rate of BOT respectively in is 55.9% 30.5% 12.5%, CA199 higher in SBOT positive rate, while CA199 in MBOT positive is higher, and of the three, it increased with increasing period.4,Intraoperative rapid freezing biopsies and postoperative pathological examination of paraffin section was 92.9%.5,Of 60 patients, all 30 of routine operation complete, comprehensive staging surgery, 27 routine conservative surgery, 33 underwent radical surgery, 12 patients had the additional chemotherapy, are mainly with platinum kind of abdominal vein combination chemotherapy, whether do chemotherapy patients with stage I compare recurrence of no significant differences.6,60 patients were followed up for 5-153 months, including five patients relapse (8.3%), recurrence in a median time of 35 months (7-84 months), in conservative surgery strip postoperative recurrence of cyst with lateral accessories cut obviously higher than (P <0.05), II, and III recurrence rates significantly higher phase I (P <0.05).7,27 routine conservative surgery with fertility requirements in 20people, currently has 8 cases of postoperative successful pregnancy, the total number of pregnancy for 14 times, eight times normal childbirth, including seven cases of natural pregnancy, 1 post-surgical 48 months line in vitro fertilization embryos transplantation boys.Conclusion: 1,BOT early sexual nonspecific clinical manifestations, conceals, duration, preoperative diagnosis nonspecific means; Three tumour marker in the diagnosis of BOT are certain limitations specificity is not high, but positive can assist the speculation disease properties and prognosis; Color Doppler ultrasound diagnostic of BOT with RI is more valuable.2,BOT operation methods and range of choices need to intraoperative frozen pathological auxiliary judgment, but because of its pathological type special, Diagnosis has the certain difficulty, so Clinical doctors should make a comprehensive judgment with lesions characteristic, patient's age and request of fertility.3,Phase I do conservative surgery is safe, Phase I postoperative chemotherapy value is not great. 4,BOT prognosis is good, Conservative surgery natural pregnancy rate is higher, but there are still a few patients for invasive cancer development, so should attach importance to the existing regularly, and particularly high risk factors, period don't late, invasive plant, micro nipple lesion, conservative surgery more should be vigilant the recurrence. |
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