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目的 探讨以急腹症为首发症状的晚期卵巢上皮癌的临床特点与预后。方法 回顾分析 1986年 1月至 1997年 12月我院收治的以急腹症作为首发症状的晚期上皮性卵巢癌 12例。结果 中位年龄 43岁 ( 346 1岁 )。Ⅲa期 1例 ,Ⅲc期 10例 ,Ⅳ期 1例。分化 1级 1例 ,2级 6例 ,3级 5例。术中发现肿瘤破裂 8例 (其中合并肿瘤扭转 2例 ,肿瘤出血 1例 ) ,单纯急腹痛 2例 ,肿瘤性肠梗阻、肠穿孔各 1例。 5例行全子宫、双附件、大网膜切除 ,7例行姑息性肿瘤切除。仅 2例手术后残留灶直径≤ 1cm。 11例术后接受铂类为基础的联合化疗 2 6疗程。生存期 <12月 9例 ,12 2 3月 2例 (包括治疗 14月后失访 1例 ) ,仅 1例存活 2 5月。 5例 ( 41 7% )有肿瘤家族史。结论 晚期上皮性卵巢癌以急腹症为首发症状者有明显的肿瘤家族史 ,预后差
Objective To investigate the clinical features and prognosis of advanced ovarian cancer with acute abdomen as the first symptom. Methods A retrospective analysis of January 1986 to December 1997 in our hospital treated with acute abdomen as the first symptom of advanced epithelial ovarian cancer in 12 cases. The median age was 43 years (346 1 years). 1 case of stage Ⅲa, 10 cases of stage Ⅲc and 1 case of stage Ⅳ. Grade 1 in 1 case, grade 2 in 6 cases and grade 3 in 5 cases. Tumor rupture was found in 8 cases (including 2 cases of tumor reversion, 1 case of tumor hemorrhage), 2 cases of simple acute abdominal pain, 1 case of intestinal obstruction and 1 case of intestinal perforation. 5 routine hysterectomy, double attachment, omental resection, palliative resection in 7 cases. Only two cases of residual tumor diameter ≤ 1cm. Eleven patients received platinum-based combination chemotherapy for 26 courses of treatment. Survival of <9 months in December, 12 cases in February 2 cases (including the disappearance of 14 cases after treatment in 1 case), only 1 case survived in May. Five patients (41.7%) had a family history of cancer. Conclusions Advanced epithelial ovarian cancer patients with acute abdomen as the first symptom have obvious family history of the tumor with poor prognosis