国际生殖健康/计划生育杂志
國際生殖健康/計劃生育雜誌
국제생식건강/계화생육잡지
JOURNLA OF INTERNATIONAL REPRODUCTIVE HEALTH/FAMILY PLANNING
2014年
4期
257-260
,共4页
卵巢肿瘤%癌%交界性%透明细胞癌%治疗%生育力%妊娠
卵巢腫瘤%癌%交界性%透明細胞癌%治療%生育力%妊娠
란소종류%암%교계성%투명세포암%치료%생육력%임신
Ovarian neoplasms%Carcinoma%Borderline%Clear cell carcinoma%Therapy%Fertility%Pregnancy
伴随全球晚婚和少育倾向越来越严重,卵巢癌的发病率也逐渐增高。临床工作中经常需要面对恶性卵巢肿瘤患者需要保留生育功能问题。目前Ⅰa期交界性卵巢瘤和Ⅰa期高分化型(G1)除外透明细胞癌的恶性上皮性卵巢癌是保留生育功能手术的适应证。手术以切除患侧附件、对侧卵巢活检、腹水细胞学检测和腹膜后[盆腔和(或)腹腔]淋巴结清扫或活检术为基本术式。由于医学伦理学很难对此开展随机对照研究得到结论性数据,造成各个国家或者机构卵巢癌保留生育手术的功能适应证和术式不一致。另一方面随着需要保留生育功能的恶性卵巢肿瘤患者的增加,保留生育功能手术的适应证是否有扩大的可能性值得探讨。
伴隨全毬晚婚和少育傾嚮越來越嚴重,卵巢癌的髮病率也逐漸增高。臨床工作中經常需要麵對噁性卵巢腫瘤患者需要保留生育功能問題。目前Ⅰa期交界性卵巢瘤和Ⅰa期高分化型(G1)除外透明細胞癌的噁性上皮性卵巢癌是保留生育功能手術的適應證。手術以切除患側附件、對側卵巢活檢、腹水細胞學檢測和腹膜後[盆腔和(或)腹腔]淋巴結清掃或活檢術為基本術式。由于醫學倫理學很難對此開展隨機對照研究得到結論性數據,造成各箇國傢或者機構卵巢癌保留生育手術的功能適應證和術式不一緻。另一方麵隨著需要保留生育功能的噁性卵巢腫瘤患者的增加,保留生育功能手術的適應證是否有擴大的可能性值得探討。
반수전구만혼화소육경향월래월엄중,란소암적발병솔야축점증고。림상공작중경상수요면대악성란소종류환자수요보류생육공능문제。목전Ⅰa기교계성란소류화Ⅰa기고분화형(G1)제외투명세포암적악성상피성란소암시보류생육공능수술적괄응증。수술이절제환측부건、대측란소활검、복수세포학검측화복막후[분강화(혹)복강]림파결청소혹활검술위기본술식。유우의학윤리학흔난대차개전수궤대조연구득도결론성수거,조성각개국가혹자궤구란소암보류생육수술적공능괄응증화술식불일치。령일방면수착수요보류생육공능적악성란소종류환자적증가,보류생육공능수술적괄응증시부유확대적가능성치득탐토。
The fertility preservation for those patients with malignant ovarian tumors are often an important problem for clinical doctors, due to more and more late marriage and fewer births, and increasing rate of ovarian cancer. The indications of preserving fertility include Ⅰa borderline ovarian tumor and Ⅰa of G1 malignant epithelial ovarian cancer except for the clear cell carcinoma. Resection of the affected uterine adnexa, and contralateral ovarian biopsy, ascites cytology and peritoneal lymph nodes (pelvic and/or abdominal) dissection or biopsy are basic surgical technique. It is difficult to carry out the randomized controlled study to get conclusive data due to medical ethics. So, there is inconsistency in indications and surgical methods of preserving fertility for those patients with ovarian cancer. On the other hand, with the increasing patients with malignant ovarian tumors, the indication of preserving fertility might be expanded. This paper reviewed these hot issues.