| Objective:The purpose of this serial study was to investigate the risk factors and prognosis factors related with malignant transformation of ovarian mature teratoma,improving the cognition of it and providing reference for standardized treatment to acquire better prognosis.Methods:The 20 cases of malignant transformation arising from mature teratoma of ovary,which were diagnosed and hospitalized in the first hospital of Jilin university during the period of December 2010 to December 2015,were defined as research group.Another 40 cases mature teratoma of ovary were randomly selected to be control group in the same period.By comparing the differences in age,tumor size,tumor markers and imaging characteristics between the two groups,the purpose of this study was to investigate the risk factors related with malignancy of mature teratoma of ovary,and to identify the relevance of age,tumor size,tumor markers,histological type and clinical stage with the prognosis of malignancy of mature teratoma of ovary.Statistical analysis: SPSS19.0 was used for descriptive statistical analysis,Univariate analysis was achieved through t test,analysis of variance and count data using c2 tests.The univariate analysis of prognostic survival was achieved through the application of Kaplan-Meier method,p <0.05 was defined as significant statistically.Results:1.The age of the 20 patients in the research group ranged from23 to 75 years,with an average age of 46.20 ± 13.11 years.In the control group,the age of the40 patientsranged from 9 to 57 years and mean age was 30.75 ± 11.76 years.The difference between the two groups was statistically significant(p <0.05).2.The tumor size of the research group was 5~16.1cm and the average tumor diameter was 9.92±3.03 cm.The tumor size of the control group was 2~15.7cm and the average tumor diameter was6.57±3.18 cm.The statistical comparison between the groups was statistically significant(p<0.05).3.All patients underwent gynecological ultrasonography.All the ultrasound image results of the two groups showed short-term or block-like echo.Research group showed tumor blood flow signal in8 cases,no blood flow signal in 12 cases,the positive rate was40%.The control group showed tumor visible blood flow signal in 5 cases,no blood flow signal in 35 cases,the positive rate was12.5%.By statistical tests,p<0.05,the difference was statistically significant.4.The positive rate of CA125 was 60%,the positive rate of CA199 was 57.1%,the positive rate of CEA was 28.6%,the positive rate of AFP was 6.7% and the positive rate of SCC-Ag was28.6% in the research groups.The positive rate of CA125 was17.5%,the positive rate of CA199 was 51.4%,the positive rate of CEA was 0,the positive rate of AFP was 2.6%,and the positive rate of SCC-Ag was 0.The positive results of CA125,CEA and SCC-Ag in the two groups were analyzed by c2 test,p<0.05,the difference was statistically significant,the positive results of CA199 and AFP in both groups were analyzed by c2 test,p>0.05,the difference was not statistically significant.5.Among the 20 patients of malignant transformation arising from mature teratoma of the ovary,There were 9 cases of the patients under the age of 46 years,8 cases survived and 1 cases died,the survival rate was 88.9%.There were 11 patients over the age of 46 years,7 cases survived and 4 cases died,the survival rate was 63.6%.There was no statistically significant difference in the prognostic outcomes between the two groups(p>0.05).6.Among the 20 patients of malignant transformation arising from mature teratoma of the ovary,there were 8 cases' tumor sizebelow 9 cm,7cases survived and 1 cases died,the survival rate was 87.5%.There were 12 patients' tumor size over 9 cm,8 cases survived and 4 cases died,the survival rate was 66.7%.There was statistically significant difference in the prognostic outcomes between the two groups(p<0.05).7.Among the 20 patients of malignant transformation arising from mature teratoma of the ovary,the positive group of CA125 had12 patients,9 cases survived and 3 cases died,the survival rate was 75%,the negative group of CA125 had 8 cases,6 cases survived and 2 cases died,the survival rate was 75%.The positive group of CA199 had 6 patients,4 cases survived and 2 cases died,the survival rate was 66.7%,the negative group of CA199 had 8cases,5 cases survived and 3 cases died,the survival rate was62.5%.The positive group of CEA had 4 patients,3 cases survived and 1 cases died,the survival rate was 75%.The negative group of CEA had 10 cases,6 cases survived and 4 cases died,the survival rate was 60%.The positive group of AFP had 1 case and no one died,the negative group of AFP had 14 cases,9 cases survived and 5 cases died,the survival rate was 64.3%.The positive group of SCC-Ag had 4 patients,1 cases survived and 3 cases died,the survival rate was 25%.the negative group of SCC-Ag had 14 cases,12 cases survived and 2 cases died,the survival rate was85.7%.there was statistically significant difference between the positive rate of SCC-Ag positive group and the negative group in the prognostic outcomes(p<0.05).There was no statistically significant difference between the positive rate of CA125,CEA,CA199 and AFP positive group and the negative group in the prognostic outcomes between the two groups(p>0.05).8.Among the 20 patients of malignant transformation arising from mature teratoma of the ovary,there were 8cases of squamous cell carcinoma,6 cases survived and 2 cases died,the survival rate was 75%.There were 7 cases of carcinoid,6 cases survived and 1cases died,the survival rate was 85.7%.There are 5 cases of other types of malignancy,3 cases survived and 2 cases died,the survival rate was 60%.There was no statistically significant difference in the prognostic outcomes in the comparative analysis of the three groups(p>0.05).9.In this study,the surgical stage of ovarian mature teratoma malignant transformation was based on FIGO(2000)primary staging of ovarian malignancy surgery staging criteria staging.There were 16 patients in phase I,15 patients survived and 1patient died,the survival rate was 93.7%.There are 4 cases in phase II or III and all died,the survival rate was 0.The difference ofthe two groups in the comparison of the survival results was statistically significant(p <0.05).Conclusions:1.The risk factors related with malignant transformation of mature teratoma of the ovary include age,tumor size,tumor blood flow signal and tumor markers CA125,CEA and SCC-Ag,including age and tumor size was positively related with maturity ovarian teratoma progression,ultrasonic tip tumor blood flow signal and tumor marker CA125,CEA and SCC Ag positive maturity ovarian teratoma should be alert to possible malignant transformation.2.The tumor size,tumor marker SCC-Ag and clinical stage of malignant transformation arising from mature teratoma of the ovary are relevant to the prognosis,including tumor diameter greater than9 cm,tumor markers SCC Ag positive and surgical pathological staging ? period and ? period above with poor prognosis. |
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