| Objective:To discuss clinical characteristics,histopathological results and intraoperative probe(tumor size,and the surrounding tissue adhesion conditions),the main operation method of the broderline ovarian epithelial tumors(BOTs)through the retrospective analysis.Exploring different factors for ovarian tumor(BOTs)after the postoperative recurrence.Methods:To retrospective analyzed and summarized in July 2005 to June 2015 QiLu Hospital of Shandong university and Shandong province hospital patients and follow-up,a total of 341 patients with broderline ovarian epithelial tumors(BOTs)were collected.Main research includes:1.The age,as the main symptoms of the patient is sick,merges common disease of department of gynaecology(or ectopic endometriosis cysts;ovarian mucous cyst)and preoperative serum CA125 values;2.Intraoperative exploration situation and histopathological diagnosis:tumor diameter,the probe in the operation situation(tumor diameter,tumor and surrounding adhesion),tumor involving the parts and histopathological diagnosis,etc.;3.Main treatment:different surgical treatment on the border of ovarian tumors(BOTs)influence the prognosis of patients.Statistical methods:The measurement data are described by the mean ± standard deviation,and the categorical data are described by frequency and percentage.The comparisons of two proportions or rates are using chi-square analysis,measurement data use t test for comparison between groups.Spearman is used for correlation analysis.Multivariate analysis is performed by unconditional logistic regression analysis.All statistical tests for bilateral inspection,inspection level is 0.05,and the statistical analysis software is SAS 9.4.Results:1.The main clinical features:the patients with broderline ovarian epithelial tumors(BOTs)between the age of 11 to 86 years,the average age of the patient was 39.65±16.66 years old.Main reason to the patient:physical examination found 234 cases of pelvic masses(68.62%),abdominal distension or abdominal discomfort found 71 cases(20.82%),12 cases of vaginal bleeding(3.52%)and other 24 cases(7.04%),such as dysmenorrhea,intraoperative serendipity,urinate discomfort,etc.).Merger of common gynecological diseases(ectopic endometriosis cysts;ovarian mucous cyst),314 patients in 341 cases of patients with preoperative serum CA125 tumor markers,the serum tumor markers CA125 of 186 cases patients was elevated,positive rate was 59.42%.There was no significant statistical differences between serum CA125 positive and postoperative recurrence,but the higher the CA125,the prompt risk of postoperative recurrence(P<0.05).2.Intraoperative exploration situation and histopathological diagnosis:in this paper,all patients received surgical treatment,of which 320 patients were intraoperative rapid frozen pathological biopsy,The consistent rate between 266 cases and postoperative histopathological results was 83.13%.Tumor types are divided into 183 cases of serous(SBOTs,53.67%),147 cases mucous(MBOTs,43.11%),others(3.23%,such as endometrial samples,mixed,clear cell type,etc.).Intraoperative probe tumours,on average,9.98± 6.10 cm in diameter,the surrounding tissue and tumor tissue adhesion of 90 cases(26.39%),according to the postoperative histopathological biopsy diagnosed,FIGO ? 303 cases(88.86%),? period 19 cases(5.57%),?period 19 cases(5.57%),? period 0 cases.Tumor involving the unilateral ovarian of 271 cases(79.47%),involving the bilateral ovaries 70 cases(20.53%),17 cases(4.99%),involving the greater omentum results involving the ovaries and involving the greater omentum on both sides have a significant statistical difference(P<0.05).MBOTs postoperative recurrence and surgery involving bilateral ovaries,tumor stage,tumor involving the correlated with greater omentum factors(P<0.05);Whether SBOTs postoperative recurrence and age,tumor involving the bilateral ovaries,correlated with the surrounding tissue and tumor tissue adhesion(P<0.05).3.Main treatment:in this paper,272 cases(79.77%)in all the 341 patients conducted laparotomy,laparoscopic surgery in 63 cases(20.23%)patients,133(39%)patients undergoing radical surgery,of which 78 patients were comprehensively staged operation.208 patients(61%)to retain reproductive function surgery(112 cases of unilateral appendix resection,simple tumor resection in 82 cases,one side accessory resection plus other tumor resection in 14).Chi-square test will study these factors respectively,the results had no significant statistical difference(P<0.05).Further classification analysis MBOTs and SBOTs surgical size and variousoperation results were no significant statistical difference(P<0.05).4.The prognosis:The mean duration of follow-up of 50.91 ±29.12 months.The patients of postoperatively with chemotherapy is 24(7.04%),recurrence in 1 case,317 patients(92.96%)without receiving chemotherapy,18 cases of postoperative recurrence.Six patients were malignant,including 2 patients died of malignant change,2 cases of end-stage cancer patientsm.Postoperatively chemotherapy can not reduce the BOTs postoperative recurrence rate(P<0.05).Conclusions:1.BOTs happened to women of childbearing age,age is mainly focused on 20-40 years old,and most of the patients diagnosed as FIGOI period.2.The hidden onset of the BOTs,most patients with no obvious discomfort or non-specific symptoms.3.MBOTs recur and surgery involving bilateral ovaries,tumor stage,tumor involving the greater omentum factors have correlation.4.SBOTs relapse easily has correlation with age,whether involving the bilateral ovaries,tumor tissue adhesioning surrounding tissue.5.This study shows that surgical path,operation method and the common disease of department of gynaecology to merge(ectopic endometriosis cysts;merger mucinous ovarian cyst),cancer affects other parts,lymph node metastasis,were no obvious difference of statistical analysis,considered the above factors has relation with the tumor recurrence. |
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