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目的:分析儿童、青少年卵巢肿瘤的临床病理特点、诊治和预后。了解保留生育后的月经恢复及生育情况。方法:收集2000年1月~2015年8月青岛大学附属医院收治的年龄<19岁的310例卵巢肿瘤患者的临床病例资料,包括发病特点、临床表现、辅助检查、治疗方法及相关预后。患者中,≤12岁81例(儿童组),13~19岁229例(青少年组)。结果:患者常见临床症状以腹痛、月经不规律为主。良性肿瘤269例(86.77%),恶性肿瘤36例(11.61%),交界性肿瘤5例(1.61%)。其中生殖细胞肿瘤最多191例(61.61%),其次是卵巢瘤样病变61例(19.68%)。儿童组中恶性及交界性肿瘤分别为14.81%(12/81)和0,青少年组中恶性及交界性肿瘤比例分别为10.48%(24/229)和2.18%(5/229)。B超及肿瘤标记物有助于卵巢良、恶性肿瘤的诊断。卵巢恶性生殖细胞肿瘤(MOGCT)大都采取保留生育功能的术式,5年总生存率、月经及后代生育情况均无明显影响。结论:儿童及青少年有腹痛、月经不规律及腹胀症状时,应充分排除卵巢肿瘤可能。儿童、青少年卵巢肿瘤有其自身特点,对恶性生殖细胞肿瘤首选保留生育功能术式。保留生育手术后生存率较高,月经及生育能力亦无不良影响。
Objective: To analyze the clinicopathological features, diagnosis, treatment and prognosis of ovarian tumors in children and adolescents. Understand the retention of menstruation after childbirth and fertility. Methods: Clinical data of 310 patients with ovarian tumors of age <19 years admitted to Qingdao University Affiliated Hospital from January 2000 to August 2015 were collected. The data included incidence characteristics, clinical manifestations, auxiliary examinations, treatment methods and related prognosis. Among the patients, 81 (≤12 years) children (group) and 229 (adolescent group) aged 13-19 years. Results: The common clinical symptoms of patients with abdominal pain, irregular menstrual. There were 269 benign tumors (86.77%), 36 malignant tumors (11.61%) and 5 borderline tumors (1.61%). Among them, germ cell tumor was the most in 191 cases (61.61%), followed by ovarian tumor-like lesions in 61 cases (19.68%). Malignant and borderline tumors in children group were 14.81% (12/81) and 0 respectively. Malignant and borderline tumors in adolescent group were 10.48% (24/229) and 2.18% (5/229), respectively. B ultrasound and tumor markers contribute to the diagnosis of benign and malignant ovarian tumors. Malignant germ cell tumors of ovary (MOGCT) mostly adopt the procedure of preserving fertility, with no significant effect on 5-year overall survival, menstruation and offspring fertility. Conclusion: Children and adolescents with abdominal pain, irregular menstruation and bloating symptoms should be fully ruled out the possibility of ovarian cancer. Children, adolescent ovarian tumors have their own characteristics, the preferred reproductive function of malignant germ cell tumors surgery. Retain the higher survival rate after fertility surgery, menstruation and fertility are no adverse effects.