Clinical Analysis Of Ovarian Tumors In Children And Adolescents

Part I :Retrospective Analysis of ovarian tumors in children andadolescentsObjective :The purpose of this study is to improve the early diagnosis rate and the prognosis by analyzing the clinical characteristics,pathological types,diagnosis and treatment of ovarian tumor in children and adolescence.Methods:I collected clinical data from 326 children and adolescent(4weeks to 19 years old)patients with ovarian tumor-like lesions and ovarian tumors admitted to the First Affiliated Hospital of Nanchang University from January 2005 to December 2017.I analyzed their incidence,clinical manifestations,and results of supplementary examinations.SPSS24.0 statistical software was used for analysis,p<0.05 was considered statistically significant.Results : The clinical symptoms of children and adolescent ovarian tumors are non-specific.The main manifestations are abdominal pain,abdominal circumference enlargement,abdominal distension and menstrual abnormalities.Abdominal pain is the primary symptom,accounting for 46.63%.It is easy to be confused with the digestive system and other diseases.Among the 326 cases of ovarian tumors,269 were benign tumors(82.51%),13 borderline tumors(3.99%),and 44 malignant tumors(13.50%).The main types of ovarian tumors were germ cell tumors,with a total of 146 cases(44.78%),followed by 99 cases(30.37%)of epithelial tumors,74 cases(22.70%)of ovarian tumor-like lesions,and 7 cases of sex cord stromal tumors(2.15%).The incidence of ovarian tumor tissue types before and after menarche was different,and germ cell tumors were predominant before menarche.The incidence of germ cell tumors after menarche decreased,and epithelial tumors increased significantly.B-mode ultrasound was the preferred auxiliary examination,and the detection rate for ovarian tumors was 51.55%.CA125 and AFP have differential diagnostic value for benign and malignant ovariantumors.CA199 and AFP have differential diagnostic value for germ cell tumors and other types of tumors.The proportion of malignant tumors in ovarian tumors >10cm in diameter increased,and there was a correlation between benign and malignant ovarian tumors and tumor size.The torsion of ovarian tumors is the main cause of adnexectomy in benign ovarian tumors.In children and adolescent ovarian tumors,there are many early and unilateral diseases.Fertility surgery should be preserved as much as possible.Conclusions :1.There are no specific clinical symptoms in children and adolescent ovarian tumors,and B-mode ultrasound is the preferred auxiliary examination.The incidence of malignant tumors with a tumor diameter greater than 10 cm is increased..2.The benign and malignant ovarian tumors in children and adolescents are mainly germ cell tumors.3.Children and adolescent ovarian tumors should be treated with fertility preservation regardless of benign or malignant disease.Part II: Diagnosis and Analysis of Ovarian Tumor-like LesionsObjective : The purpose of the study is to summarize the clinical features of ovarian tumor-like lesions,and to compare the ovarian tumor-like lesions with benign and malignant ovarian tumors,to further understand the pathogenesis of ovarian tumor-like lesions,in order to improve the diagnostic accuracy,avoid excessive treatment,improve outcomes and Prognosis.Methods:I collected the clinical data of 326 children and adolescent(4 weeks to19 years old)ovarian tumor patients and ovarian cancer patients admitted to the First Affiliated Hospital of Nanchang University from January 2005 to December 2017,and analyzed their incidence situation,clinical manifestations,auxiliary examination results,etc.SPSS24.0 statistical software was used for analysis,p<0.05 was considered statistically significant.Results :In this study,ovarian cyst-like lesions were most common with simplecysts,followed by follicular cysts.The clinical manifestations of patients with ovarian tumor-like lesions were non-specific,mainly abdominal pain,accounting for 46.87%.The tumor markers CA199 and CA125 were different in ovarian tumor-like lesions and benign ovarian tumors(p<0.05).Among them,CA199 had high diagnostic value for both of them.The CA199 value of 15.61 U/ml differentiated ovarian tumor-like lesions from benign lesions.Ovarian tumors have the highest value.CA125 and AFP were significantly different in ovarian tumor-like lesions and malignant ovarian tumors(p<0.05).CA125 value of 21.05U/ml,AFP value of 1.50ng/ml distinguish between ovarian tumor-like lesions and malignant ovarian tumors the highest value.There were differences in the distribution of different types of ultrasound sonography in tumor-like lesions and benign and malignant tumors(p < 0.05).Cystic lesions were mainly cystic lesions,some were cystic,and benign tumors were cystic and cystic.Mainly,malignant tumors are mainly mixed and solid,with the highest malignant tumor rate.The sizes of tumor-like lesions,benign tumors,and malignant tumors were 8.23±6.32 cm,14.05±10.39 cm,and 21.56±11.0cm,respectively.There was a statistically significant difference in lesion size between any two groups(p< 0.05).The area under the ROC curve analysis,the maximum diameter of the tumor 7.7cm as a critical value to distinguish between tumor-like lesions and benign tumors,tumor diameter 10.2cm as a critical value to distinguish between tumor-like lesions and malignant tumors.Conclusions :1.The diameter of the mass,the sonographic features,and the tumor marker values have differential diagnostic value for ovarian tumor-like lesions and benign and malignant ovarian tumors.2.Tumor diameter less than or equal to 7.7cm,cystic ultrasound,and/or CA199 less than or equal to 15.61U/ml,CA125 less than or equal to 21.05U/ml,AFP less than or equal to 1.50ng/ml,no other signs of malignancy The distinction between ovarian tumor-like lesions and benign and malignant ovarian tumors is of higher value.