卵巢非侵袭性低级别浆液性癌保留生育功能手术五例及文献复习

摘要

Objective To investigate the characteristics of fertility-sparing surgery for non-invasive low-grade serous carcinoma ( LGSC) of the ovary .Methods All the histologically diagnosed patients of non-inva-sive LGSC who admitted to Peking Union Medical College Hospital and received fertility -sparing surgeries between January 2015 and June 2015 were reviewed and their clinicopathological characteristics , surgical procedures , and follow-up results were retrospectively analyzed .Results Totally five cases of non-invasive LGSC receiving fertili-ty-sparing surgeries were reviewed .Their median age was 29 years (range, 24-34 years).One case received laparotomy and four received laparoscopies; four cases received ovarian cystectomy and one received emergency unilateral adnexectomy for the affected and necrotic ovary because of acute torsion .One case was diagnosed at In-ternational Federation of Gynecology and Obstetrics ( FIGO) stage IB, and the other four were at stage IA .All the five cases received no further therapy after the surgery .The median follow-up period was 7 months ( range , 6-12 months ) .No case relapsed so far .One case conceived naturally and both the mother and the fetus were in good condition .Conclusions For non-invasive LGSC patients , there are many unresolved issues in aspects of spare of fertility , conception after fertility-sparing surgeries , recurrence , and follow-up.Although the possibility to spare the ovary is supported by this study for young non-invasive LGSC patients , long-term prognosis ( inclu-ding fertility and survival ) needs to be observed in further follow-up.%目的：分析卵巢非侵袭性低级别浆液性癌（ low-grade serous carcinoma， LGSC）患者保留生育功能手术的特点。方法回顾性收集2015年1月至2015年6月北京协和医院病理诊断为卵巢非侵袭性LGSC且进行保留生育功能手术的患者，对其临床病理特点、手术过程和随访情况进行总结。结果共有5例非侵袭性LGSC且保留生育功能患者，中位年龄29岁（24～34岁）；1例行开腹手术，4例行腹腔镜手术；4例手术行卵巢囊肿剔除，1例患者因为卵巢急性扭转坏死行受累附件切除。1例国际妇产科联盟（ International Federation of Gynecology and Obstetrics， FIGO）分期为IB期，4例为IA期。所有患者术后均未接受进一步治疗。中位随访7个月（6～12个月），所有患者均未复发，1例患者自然受孕且母胎情况良好。结论对于非侵袭性LGSC患者，能否保留生育功能、保留生育功能手术术后的生育情况、复发率及随诊方案，仍是目前临床处理的棘手问题。本研究为年轻的非侵袭性LGSC患者提供了保留卵巢的选择，但患者的长期预后（包括生育和生存）尚有待进一步随访。