| Objective:Considering the pathological type as a main principle in classification,preliminary study on pathological characteristics and different prognosis of non benign ovarian tumors,thus to deepen the understanding of their biological behavior.Methods: To collect clinical datum of 175 patients with non benign tumors who were diagnosed and surgically treated in Wannan Medical College Affiliated Yiji Mountain hospital department of gynaecology from Feb.2005 to Dec.2010,and then divide them into two groups,one is eithelial cell group,which includes borderline ovarian tumor(BOT)group and epithelial ovarian cancer(EOC)group,the other one is non-eithelial cell group,which includes less common ovarian histopathologies(LOCH)group and secondary tumor(ST)group.Then retrospectively to analyse the treatment information of patients in each group,including medical history,lesions,surgical treatment,postoperative auxiliary treatment and follow-up information etc.,thus generally to conclude the identification characteristics among groups of ovarian benign tumors.Results: According to its pathological features,these cases are divided into four groups,which of 27 cases(15.43%)in BOT group,of 130 cases(74.29%)in EOC group,of 11 cases(6.29%)in LOCH group and 4 cases(4%)in ST group.The average age of 175 patients in this research is(51.43 ± 11.41)years,appearing negative skewness distribution between 11-69 years old.According to FIGO stage,168 cases primary ovarian tumors patients include,I-stage: 27 cases(16.07%);II-stage: 37 cases (22.02%);III-stage: 76 cases(45.24%)and IV-stage: 28 cases(16.67%).In 157 cases of epithelial tumor patients,the average onset age of BOT group is(41.70± 5.14)years old,the average onset age of EOC group is(56.92 ± 4.71)years old.27 patients BOT group of BOT group are not menopause,while 18 cases(51.43%)in early stage of EOC group are menopause and 81 patients(85.26%)in late stage of EOC group are menopause.By Clinical staging,BOT is more frequently seen in early cases,of which 13 cases(48.15%)in I-stage and 12 cases(44.4%)in II-stage,while EOC group are more in advanced cases seen,of which 67 cases(70.53%)in III-stage and 28 cases(29.47%)in IV-stage.Patients of the both two groups are as the most common in serous lesions,of which the BOT group reaches 40.74%(11 cases)and EOC group is 46.92%(61 cases)in this research.Defined serum CA125>35U/ml as positive,the positive rate of each group respectively is BOT group 81.48%(22 cases),group of early EOC 94.2%(33 cases)and advanced EOC group is 100%(95 cases).Combined with preoperative ultrasonography,ovarian tumor size found in operation of clinical staging are respectively: stage-?:(101.07±17.71)mm;stage-?:(94.52±11.41)mm;stage-?:(73.36±10.96)mm and stage-?:(85.21±7.10)mm,generally showing a downward trend.Among 27 cases of BOT patients,10 cases of survial within 3 years and loss of 17 cases,while 2 cases of recurrence within 5 years and others lost to follow-up.About 130 cases of EOC patients,The postoperative mean survival time of clinical staging are respectively : stage I:(59.21 ± 1.66)months;phase II:(52.57 ±6.75)months;phase III:(44.59 ± 11.09)months;IV:(46.13 ± 8.74)months,and the 3-year and 5-year survival rate in each group show a downward trend.The average age of onset of LOCH group is(21.27 ±7.30)years,and all of the sample are one side,which the average size of the tumor are(62.27 ± 4.92)mm.Patients of this group include variety of different types of tissue pathology,and there are 7 cases of FIGO stage-II and 4 cases of FIGO stage-III.The postoperative 3-year survival rate reaches 90.91%,while 5-year survival rate is 81.82%.7 cases of ovarian metastatic tumors are all originated from gastrointestinal tract tumors and their histology take the majority of singnet cell carcinoma.The mean onset age of this group is(34.29 ± 2.75)years old.They are solid or semi solid lesions in bilateral ovarian,and the size of the middle on the left and right.The patients are accompanied with different degrees of ascites sign,even some gastrointestinal symptoms,and 5 cases(71.43%)of patients with serum CEA detection of positive indicators(> 5?g /L).All of these 7 patients have retroperitoneal lymph node metastasis,while 4 cases(57.14%)are even accompanied by abdominal pelvic organ metastasis,and the average survival time is(11.07 ± 2.94)months.Conclusion: Non benign ovarian tumors can occur in all age groups of women,and the majority of epithelial lesions in histological studies,which can be roughly divided into two types of borderline lesions and cancer,while the latter one is larger in quantity.Borderline tumors are more common in clinical early stage,while the cancer is mainly in the late stage,of which the age of onset is delayed,and the proportion of menopause patients is high.Four main kinds of histological classification included serous,mucinous,endometrial,and clear cell like changes,with serous lesions in majority.To some extent,the serum CA125 level can indicate the difference of epithelial ovarian tumor.Overall,increasing with the clinical stage,the survival rate of epithelial lesions decreased,and the survival time obviously shorten.LOCH patients are more common in young women and young girls,and selection of specific treatment options can significantly improve its prognosis.Krukenberg tumor is the most common metastasis ovarian,which lymph node metastasis so fast and its prognosis is very poor. |
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