通过分析卵巢癌肉瘤的临床表现、体征、临床资料、诊疗过程及生存结局,结合国内外文献,总结最新诊疗方法,进而提升对该疾病的认识。本文回顾性分析青岛大学附属医院收治的5例卵巢癌肉瘤患者的临床表现以及诊断与治疗经验,并对相关文献进行回顾总结。所有患者均未出现特定症状,且糖类抗原125 (CA125)和人附睾蛋白4 (HE4)水平均升高。影像学检查显示4例患者为单侧卵巢肿瘤,1例患者累及双侧卵巢。增强CT扫描显示囊实性肿块,实性部分明显增强。5例患者均接受手术治疗,术后行紫杉醇和铂类化疗。3例患者没有复发或转移,1例患者复发后行维持化疗,1例患者死于复发和转移。By analyzing the clinical manifestations, signs, clinical data, diagnosis and treatment process, and survival outcomes of ovarian carcinosarcoma, combined with domestic and foreign literature, the latest diagnosis and treatment methods are summarized to enhance the understanding of this disease. This article retrospectively analyzes the clinical manifestations, diagnosis, and treatment experience of 5 patients with ovarian carcinosarcoma admitted to the Affiliated Hospital of Qingdao University, and reviews and summarizes related literature. All patients did not exhibit specific symptoms, and the levels of carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) were elevated. Imaging examinations showed that 4 patients had unilateral ovarian tumors, and 1 patient involved both ovaries. Enhanced CT scan shows a cystic solid mass with significant enhancement in the solid part. All 5 patients underwent surgical treatment, followed by paclitaxel and platinum-based chemotherapy. Three patients did not experience recurrence or metastasis, one patient underwent maintenance chemotherapy after recurrence, and one patient died from recurrence and metastasis.
目的:研究国际卵巢肿瘤分析组织(International Ovarian Tumor Analysis,IOTA)附件多元模型(Assessment of Different NEoplasias in the adneXa,ADNEX)术前鉴别转移性卵巢癌与原发性卵巢癌的临床价值。方法:收集2016年3月至2021年4月在我院行手术治疗的卵巢恶性肿瘤患者术前予超声检查,并记录模型预判结果,以术后病理结果为金标准,计算ADNEX模型纳入、不纳入CA125时鉴别转移性与原发性卵巢癌的灵敏度、特异度及受试者操作特征(receiver operating characteristic,ROC)曲线下面积。结果:本研究纳入卵巢恶性肿瘤患者共197例,其中原发性卵巢癌153例(Ⅰ期36例,Ⅱ~Ⅳ期117例),转移性卵巢癌44例。ADNEX模型不纳入CA125时,鉴别转移性与原发性卵巢癌的ROC曲线下面积为0.621(95%置信区间为0.534~0.708),灵敏度为93.2%,特异度为31.4%;ADNEX模型纳入CA125时,鉴别转移性与原发性卵巢癌的ROC曲线下面积为0.810(95%置信区间为0.747~0.872),灵敏度为79.5%,特异度为69.3%。ADNEX模型纳入与不纳入CA125结果间差异有统计学意义(P<0.001)。结论:ADNEX模型对于转移性与原发性卵巢癌的鉴别有较好的临床价值,纳入CA125能提高模型的诊断效能。