| Objective:Retrospective analysis of ovarian borderline tumors(borderline ovarian tumors,BOTs)in patients with clinical data,after treatment and recurrence.To investigate the clinical characteristics of BOT,operation mode and transvaginal ultrasound in the preoperative diagnosis and follow-up of value,and then,provide more evidence for the treatment of BOT.Methods: To choose the chizhou hospital from March 2005-Oct 2015 and by postoperative pathology confirmed the diagnosis of ovarian junction tumors,54 cases of clinical data of the patients were enrolled in this study.Retrospectively analyzed the clinical manifestation,auxiliary examination,surgical and postoperative pathological results,follow-up and recurrence.Results: 1.clinical characteristics: 54 patients were newly diagnosed,the youngest is 20 years old,the biggest 75 years old,and the average age was 43±5 years old.“The medical examination found that pelvic” masses diagnosed most,accounting for 59.26%(32 / 54),followed by " abdominal distension ".2.Preoperative detection of tumor markers and transvaginal ultrasound features All of the 54 patients had the preoperative tumor markers(CAl25,CAl99,CEA).Among them,29 cases of patients with elevated CAl25,13 cases of patients with elevated CAl99,7cases with elevated CEA,11 cases with elevated CAl25 and CAl99,6 cases with elevated CAl25 and CEA,4 cases with three tumor markers elevated.54 cases of patients before operation were transvaginal ultrasound examination in our hospital,and discovered prompt pelvic or abdominal and pelvic cystic mass about 85.19%(46 /54),ultrasound detected inside the lump papillary structures about 59.26%(32/54),ultrasound probe packets within the block blood flow signal about 53.70%(29/54);(showing)ultrasound showed cystic package about 14.81%.3.With frozen biopsy results and postoperative pathological examination results in operation In 54 patients,except for 1 cases of tumor torsion had emergency surgery in night intraoperative frozen biopsy,the others underwent intraoperative frozen section examination.Frozen section examination and routine pathological examination results of BOT,SBOT,MBOT in the coincidence rate were 92.45%,95%,90.63%.Intraoperative pathological diagnosis rate is higher,a higher coincidence rate and postoperative routine pathology,has important significance for further treatment,the pathological types of diagnostic accuracy may be affected.According to the 2013 FIG0 staging,43 patients of I,accounting for 79.63%,8 patients of II,accounting for 14.81%,3 patients of III,accounting for 5.56%.4.The significance of greater omentum resection surgery and intraoperative 54 cases of BOT underwent comprehensive staging surgery in 21 cases,and 33 cases were treated with conservative surgery.32 cases with different degrees of omentum surgery,among them,3 cases of omental implant.The greater omentum implantation rate was9.38%.Among them,5 cases underwent omental biopsy(15.63%)accounted for and found no greater omentum plant;8 patients underwent partial omentum resection surgery accounted for(25.0%),1 case with omental implantation;19 patients underwent colon greater omentum resection for(59.37%),2 cases have greater omentum plant.We can see that the consistency of the results with higher visual inspection results and microscope,the intraoperative visual inspection of normal omentum is safe according to result.5.The operation way and the recovery of menstruation and pregnancy 33 patients underwent conservative surgery,including 15 cases with abdominal surgery and 18 cases of retained reproductive function with laparoscopic surgery.33 cases of conservative surgery were followed up,of which 4 cases were lost,29 patientscompleted follow-up.The follow-up time was 3-127 months,median 25 months.Among them,19 cases had plans of pregnancy,and had 12 pregnancies,7 cases of full-term delivery,2 cases of tubal pregnancy,3 cases of early pregnancy embryo stop.Two kinds of surgical approach on fertility preserving surgery(laparoscopic and abdominal)were compared.Laparoscopic surgery group and after abdominal surgery group,postoperative pregnancy rate was 60% and 66.7%.Respectively,postoperative pregnancy time interval averaging 13 + 461 and 20 + 552 months,after menses time average 2.7 + 1.12 and 2.73 + 8.32 months.The comparison between the two groups of pregnancy rate,term yield,postoperative pregnancy interval and postoperative menses time were not statistically significant.6.Application of ultrasound in postoperative follow-up Follow up of 54 cases of BOT patients,including 21 cases of comprehensive staging surgery patients with 3cases were lost,33 cases underwent fertility sparing surgery with 4 cases were lost.The follow-up time was 3-127 months,median 25 months,a total of 47 patients completed follow-up.The follow-up including gynecological examination,B ultrasound,tumor markers CA125,CA199.Comprehensive staging in 18 cases,4 cases of recurrence,29 cases of conservative surgery had 2 cases of recurrence,a total of 6 cases of recurrence,the recurrence rate(12.77%).B ultrasound were recurrent cases,were significantly abnormal,the small number of cases,but that ultrasonography has important significance in the postoperative follow-up.Conclusion: 1.Statistics of ovarian mucinous borderline tumor and pathological examination of intraoperative frozen section examination with low rate,need to cause pathological doctor and surgeon alert..2.Transvaginal ultrasound sonographic abnormalities,especially mass within the papillary structure,mass flow rich,to guard against ovarian cancer.3.Laparoscopic conservative surgery and abdominal surgery and the difference between the pregnancy and menstrual recovery.Omental planting occurs in advanced pathology,intraoperative exploration stage early,visual inspection of theomentum is normal,keep safe.4.Ultrasound examination of patients with recurrent BOT were detected,so BOT in the follow-up of patients,regular ultrasound examination is meaningful. |
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