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目的探讨输卵管交界性肿瘤的临床病理学特征及诊治要点。方法回顾性分析5例输卵管交界性肿瘤患者及文献报道的21例患者的临床及病理学资料。结果 26例患者年龄3～75岁,平均36.1岁,主要临床表现为下腹痛(30.8%)和盆腔包块(84%),超声检查可于附件区探及囊性包块内有中强乳头状回声,血清CAl25水平多正常(<35 U/ml)或仅轻度升高(平均89.9 U/ml);肿瘤多局限于一侧输卵管或系膜内(96.2%,25/26),直径1.7～13 cm,平均5.8 cm,22例为囊性,其中73%内壁有乳头突起,3例为实性,组织学类型以浆液性肿瘤(69.2%,18/26)居多;手术方式2例不详,16例行保留生育功能的手术,其中3例采取全面分期/再分期手术,13例未分期,仅行肿瘤剔除(4例)、输卵管部分或全部切除(6例)或患侧附件切除(3例),其余8例接受子宫及双附件切除术,其中2例行全面分期/再分期手术;术后随访6～84个月,均无复发。结论输卵管交界性肿瘤好发于年轻女性,临床表现缺乏特异性,术前诊断困难,确诊依靠手术探查及病理检查,诊断时多为早期,预后好,保留生育功能的保守性手术是安全可行的,全面分期手术的治疗意义有待观察,进一步的结论需积累更多病例加以明确。
Objective To investigate the clinicopathological features and diagnosis and treatment of tubal borderline tumors. Methods The clinical and pathological data of 5 patients with borderline tubal tumor and 21 patients reported in the literature were retrospectively analyzed. Results 26 patients aged 3 to 75 years (average 36.1 years), the main clinical manifestations of lower abdominal pain (30.8%) and pelvic mass (84%), ultrasound examination in the annex area and cystic mass with a strong nipple Echocardiography, serum CA125 levels were normal (<35 U / ml) or only mild (average 89.9 U / ml); tumors were mostly localized in one side of the fallopian tube or mesangial (96.2%, 25/26) 1.7 to 13 cm, an average of 5.8 cm, 22 cases of cystic, of which 73% of the wall has papillae, solid in 3 cases, histological type of serous tumors (69.2%, 18/26) Unknown, 16 cases of reproductive function retained surgery, of which 3 cases to take a comprehensive staging / re-staging surgery, 13 cases were not staging, only tumor excision (4 cases), tubal partial or total resection (6 cases) or ipsilateral attachment resection (3 cases). The remaining 8 cases underwent hysterectomy and double attachment resection. Among them, 2 cases underwent complete staging / re-staging. All cases were followed up for 6 to 84 months without recurrence. Conclusions The tubal borderline tumor occurs in young women. The clinical manifestations are lack of specificity. It is difficult to diagnose before operation. The diagnosis depends on surgical exploration and pathological examination. Early diagnosis and prognosis are good, and conservative surgery with reproductive function is safe and feasible , The significance of the treatment of comprehensive staging surgery remains to be seen, further conclusions need to be accumulated more cases to be clear.