目的 分析良性病变子宫切除术后盆腔恶性肿瘤的临床特征。方法 收集首都医科大学附属北京妇产医院2013-01至2022-06收治的因子宫或附件良性病变行全子宫或次全子宫切除术的患者72例,依据子宫切除术后盆腔肿物病理类型分为良性疾病组(49例)及恶性肿瘤组(23例),回顾性分析其临床特征及高危因素。结果 恶性肿瘤组行子宫切除时年龄、发现盆腔肿物时年龄、盆腔肿物发生距离子宫切除时间间隔均高于良性疾病组,差异有统计学意义(P<0.05)。恶性肿瘤组73.9%患者有腹痛腹胀、阴道出血或排液等临床症状,仅有26.1%患者为体检时发现,与良性疾病组比较差异有统计学意义(P<0.05)。恶性肿瘤组患者超声影像全部表现为实性或囊实性、较大体积盆腔肿物,伴有不同程度的肿瘤标志物升高,与良性疾病组比较差异有统计学意义(P<0.05)。结论 恶性肿瘤易发生于年龄较大时切除子宫、距离子宫切除间隔5年以上者,且多数患者有临床症状。对于此类患者一旦发现盆腔肿物,要结合肿物影像学特点、血清肿瘤标志物水平、患者症状等综合进行分析,尽早手术治疗,以免延误病情。
Abstract
Objective To analyze the clinical characteristics of malignant pelvic tumors after hysterectomy for benign lesions. Methods A total of 72 patients who underwent total or subtotal hysterectomy due to benign uterine or adrenal lesions were collected from Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from January 2013 to June 2022. According to pathological types of pelvic masses after hysterectomy, they were divided into benign disease group (49 cases) and malignant tumor group (23 cases). The clinical features and risk factors were analyzed retrospectively. Results The age at hysterectomy, the age at the discovery of pelvic mass, and the time interval between the occurrence of pelvic mass and hysterectomy in the malignant tumor group were higher than those in the benign tumor group, with statistical significance (P<0.05). In the malignant tumor group, 73.9% of the patients had abdominal pain, abdominal distension, vaginal bleeding or drainage and other clinical symptoms, while only 26.1% of the patients were found during physical examination, and the difference was statistically significant compared with the benign disease group (P<0.05). The ultrasound images of all patients in the malignant tumor group showed solid or cystic solid pelvic masses with large volume, accompanied by increased tumor markers of different degrees, and the difference was statistically significant compared with the benign tumor group (P<0.05). Conclusions Malignant tumors are more likely to occur in older patients with hysterectomy with interval of more than 5 years, and most patients have clinical symptoms. Once pelvic masses are found in such patients, comprehensive analysis should be carried out in combination with the imaging characteristics of the tumor, the level of serum tumor markers, and the symptoms of the patients, and early surgical treatment should be performed to avoid the delay of the disease.
关键词
子宫切除术 /
盆腔肿物 /
恶性肿瘤
Key words
hysterectomy /
pelvic mass /
malignant tumor
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参考文献
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