剖腹探查女性生殖器官疾病时常规卵巢活检的“益处”

M. Szymański, Radosław Janicki, Magdalena Czekien, W. Szymański
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摘要

背景:卵巢癌是波兰诊断为生殖器官癌症的患者中最常见的死亡原因。尽管癌症治疗的诊断技术和方法不断进步和改进,但卵巢癌的流行病学和自然史基本保持不变。大约四分之三的卵巢癌病例直到疾病的第三或第四阶段才被发现或治疗。目前的常规诊断程序包括超声检查、生物化学标志物评估和卵巢组织病理评估以确认诊断。卵巢癌的术前诊断仍然令人不满意,寻找新的有效方法也没有提供令人满意的结果。目的:探讨卵巢宏观变化的常规活检是否有足够的疗效。材料和方法:我们进行了一项涉及约1000个卵巢的临床试验,这些卵巢在生殖器官手术中收集组织样本,并由病理学家检查组织。采用Spearman秩相关对结果进行统计比较。结果:99.8%的患者卵巢宏观不变的组织病理学评价结果正常。结论:在这种情况下,常规活检的宏观不变的卵巢不能提供足够的好处。此外,它可能与手术并发症的增加有关,如活检部位出血。因此,除非怀疑癌症,否则在生殖器官手术期间不应常规进行卵巢活检。
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“Benefit” of Routine Ovarian Biopsy during Laparotomy for Diseases of the Female Reproductive Organs.
Background: Ovarian cancer is the most common cause of death among patients diagnosed with reproductive organ cancers in Poland. Despite the progress and continual improvements in diagnostic techniques and methods of cancer treatment, the epidemiology and natural history of ovarian cancer remain largely unchanged. Approximately three quarters of ovarian carcinoma cases are not detected or treated until the third or fourth stage of the disease. The current routine diagnostic procedures include ultrasound examination, biochemistry marker assessments and histopathological evaluations of ovarian tissue to confirm a diagnosis. The preoperative diagnosis of ovarian cancer remains unsatisfactory, and the search for new effective methods has not provided satisfactory results.Objectives: To determine whether routine biopsy of macroscopically unchanged ovaries provides sufficient benefit.Material and methods: We conducted a clinical trial involving approximately 1,000 ovaries from which tissue samples were collected during reproductive organ surgeries, and the tissues were examined by a pathologist. Spearman’s rank correlation was used to compare the results statistically.Results: The results of the histopathological evaluation of macroscopically unchanged ovaries were normal in 99.8% of patients.Conclusion: In this context, routine biopsy of macroscopically unchanged ovaries does not provide sufficient benefit. Moreover, it may be associated with increases in surgical complications such as bleeding from the biopsy site. Therefore, biopsy of the ovaries during surgery of reproductive organs should not be performed routinely unless cancer is suspected.
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