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目的探讨卵巢交界性上皮肿瘤的临床病理诊断标准、肿瘤组织特殊形态结构及生物学行为特征。方法收集66例卵巢上皮性交界性肿瘤的临床资料,分别观察上皮增生层次,筛孔状及微乳头状结构、细胞的异型性、分离的细胞簇、较少的核分裂数及微浸润等病理形态;肿瘤分期按国际妇产科联合会(FIGO)标准,Ⅰ期43例,Ⅱ期9例,Ⅲ期14例。结果66例交界瘤,上皮细胞呈明显的复层增生的形态占80%(53/66),细胞核异型在轻-中以上,核分裂象≤3/10HPF,为75.8%(50/66),分离的细胞簇及复层增生占69.7%(46/66),呈微乳头及筛孔状结构占27.3%(18/66),伴微浸润18.1%(9/66)。22例伴表面生长浆交瘤,14例出现腹膜种植,淋巴结受累9例;随访时间超过5年的患者5年生存率100%。结论卵巢交界性肿瘤预后较好,淋巴结受累及腹膜种植灶不改变患者预后,对年轻的I期患者应尽可能保留其生育能力。
Objective To investigate the clinical and pathological diagnostic criteria of ovarian borderline epithelial tumors, the special morphological structure and biological behavior of tumor tissues. Methods The clinical data of 66 cases of ovarian epithelial borderline tumors were collected. The epithelial hyperplasia, mesopore and micropapillary structures, cell atypia, isolated cell clusters, fewer mitotic numbers and microinvasions were observed. ; Tumor staging by the International Federation of Obstetrics and Gynecology (FIGO) standard, 43 cases of stage Ⅰ, 9 cases of stage Ⅱ, 14 cases of stage Ⅲ. Results In 66 cases of borderline tumors, the morphology of epithelial cells with obvious hyperplasia was 80% (53/66), the nuclear atypia was above or below the light - middle level, the mitotic figures were ≤3 / 10HPF, which was 75.8% (50/66) 69.7% (46/66) of the cells were clustered and hyperplasia of the hyperplasia, with micro-papilla and sieve-like structure accounting for 27.3% (18/66) and microinvasive invasion 18.1% (9/66). Twenty-two patients with surface growth plasma were treated by tumor growth, 14 patients had peritoneal implantation, and 9 patients had lymph node involvement. The 5-year survival rate was 100% in patients who were followed up for more than 5 years. Conclusion The prognosis of borderline ovarian tumor is better, lymph node involvement and peritoneal implantation do not change the prognosis of patients, young I patients should retain their fertility as much as possible.