卵巢与卵巢肿瘤.ppt

卵巢肿瘤(ovariantumor)复旦大学附属妇产科医院2卵巢与卵巢肿瘤卵巢起源、结构及周围组织关系皮质:基质、白膜、表面上皮细胞、间质细胞、各级卵泡(卵细胞、颗粒细胞、卵泡膜细胞)→黄体→白体髓质:基质、血管、神经→卵巢门→悬韧带卵巢系膜:卵巢冠卵巢门:卵巢网卵巢肿瘤组织来源上皮性肿瘤性索间质肿瘤生殖细胞肿瘤SerousMucinousEndometrioidClearcellTransitionalcell(Brenner)纤维上皮瘤MixedepithelialUndiferentiatedandunclassifiedDysgerminomaYolksactumorEmbryonalcarcinomaPolyembryomaNon-gestationalchoriocarcinomaTeratomaMatureImmatureDermoidcystSertoli-Leydigcelltumor(Androblastoma)Krukenbergtumor:ametastaticmucinous/-ringcelladenocarcinomaofovarieswhichtypicalyoriginatesfromprimarytumorsoftheGItract,%~70%20%~40%5%5%~10%?表面上皮-间质肿瘤(Surfaceepithelial-stromaltumors)?性索-间质肿瘤(Sexcord-stromaltumors)?生殖细胞肿瘤(Germcelltumors)?混合性生殖细胞-性索-间质肿瘤(Mixedgermcell-sexcord-stromaltumors)?卵巢网肿瘤及相关病变(Tumorsandrelatedlesions)?性质混杂的卵巢肿瘤及卵巢瘤样病变(Miscellaneoustumoursandtumour-likeconditionsofovary)?淋巴瘤与白血病(Lymphomasandleukaemias)?卵巢继发性肿瘤(Secondarytumoursoftheovery)?瘤样病变(Tumor-likelesions)(WHO,2002,法国Lyon),,、,化疗也极为重要BenignBorderlineMalignant上皮性肿瘤育龄:%生殖细胞恶性肿瘤:可见于20~30岁,年龄更大的罕见<20岁:70%的卵巢肿瘤为生殖细胞来源,其中1/3为恶性75%无性细胞瘤发生于10-30岁,10%-15%为双侧颗粒细胞瘤:青春期前患者占5%;其它分布于各年龄段;双侧病变仅占2%5%伴发子宫内膜癌,25%-50%合并子宫内膜增生支持细胞间质细胞肿瘤:罕见,常见于20-40岁,<40岁占75%,双侧性<1%卵巢恶性肿瘤:%20×73%+5×45%+58×21%+17×5%临床表现(1)、腹痛、、消瘦、