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目的 探讨少女生殖道恶性肿瘤的临床特点、治疗方法和疗效。方法 回顾性分析 2 7例少女生殖道恶性肿瘤的临床资料。结果 患儿的年龄为 2～ 12岁 ,平均 6 5岁。卵巢恶性肿瘤 2 3例 ,其中卵巢恶性生殖细胞肿瘤 2 1例 ,占 77 8% ;性腺外恶性肿瘤 4例 ,包括阴道内胚窦瘤 2例 ,阴道和盆腔横纹肌肉瘤各 1例。卵巢恶性肿瘤的临床表现主要为腹痛和腹部包块 ,分别为 77 8%和74 1% ;而阴道恶性肿瘤的临床表现 ,主要为阴道流血和阴道肿块。 91 3% (2 1/ 2 3)的患儿仅行患侧附件切除术 ,保留了子宫和对侧卵巢。少女生殖道恶性肿瘤对化学治疗 (化疗 )十分敏感 ,术后根据高危因素不同 ,分别给予顺铂、长春新碱、博莱霉素 (PVB)方案 ,顺铂、鬼臼素、博莱霉素 (PEB)方案或长春新碱、更生霉素、环磷酰胺 (VAC)方案化疗。在平均为 47 4个月的随诊期内 ,生存率达 71 4%。结论 卵巢恶性生殖细胞肿瘤对化疗十分敏感 ,应作为主要的治疗手段。手术的原则应保留生育功能。
Objective To investigate the clinical features, treatment and efficacy of reproductive tract cancer in girls. Methods The clinical data of 27 girls with reproductive tract cancer were retrospectively analyzed. Results The children were from 2 to 12 years old with an average of 65 years old. 21 cases of ovarian malignant tumors, of which 21 cases of malignant ovarian germ cell tumors, accounting for 77.8%; 4 cases of extragonadal malignant tumors, including vaginal endodermal sinus tumors in 2 cases, vaginal and pelvic rhabdomyosarcoma in 1 case. The main clinical manifestations of ovarian cancer were abdominal pain and abdominal mass, which were 77.8% and 74.1% respectively. The clinical manifestations of vaginal malignancies were mainly vaginal bleeding and vaginal mass. 91 3% (2 1/2 3) of the children only ipsilateral attachment excision, retained the uterus and contralateral ovary. Girls reproductive tract cancer is very sensitive to chemotherapy (chemotherapy), postoperative according to different risk factors were given cisplatin, vincristine, bleomycin (PVB) program, cisplatin, podophyllotoxin, bleomycin (PEB) regimen or vincristine, dactinomycin, cyclophosphamide (VAC) regimen chemotherapy. In an average of 474 months of follow-up period, the survival rate of 71 4%. Conclusions Ovarian malignant germ cell tumors are very sensitive to chemotherapy and should be used as the main treatment. The principle of surgery should retain reproductive function.