Objective: To investigate the diagnosis, treatment and prognosis of ovarian yolk sac tumor (OYST). Methods: The clinicopathological data and follow-up data of 12 patients with OYST admitted to the Affiliated Hospital of Qingdao University from January 2013 to December 2020 were retrospectively analyzed, and the diagnosis, treatment and prognosis of OYST patients were summarized. Results: (1) The age of 12 patients with OYST ranged from 11 to 37 years, with a median age of 20 years. At the first visit, all 12 patients had pelvic masses. Reasons for seeing a doctor: 6 cases of abdominal distension and abdominal pain, 4 cases of mass in the lower abdomen, 1 case of vaginal bleeding, and 1 case of appendicitis. International Federation of Obstetrics and Gynecology (FIGO) 2014 staging: 4 cases in stage Ⅰa, 2 cases in stage Ⅰc, 1 case in stage Ⅱc, 4 cases in stage Ⅲc, and 1 case in stage Ⅳb. (2) All 12 patients were examined by color Doppler ultrasound before operation, among which 10 cases showed unilateral adnexal masses and 2 cases bilateral adnexal masses. The median maximum diameter of tumor was 16.5 cm (range: 6.0-28.0 cm). The preoperative levels of alpha fetoprotein (AFP) in 12 patients (all >1 210 μg/L) were significantly higher than normal (<25 μg/L). Among the 11 patients with cancer antigen 125 (CA125) detection results, 9 patients showed elevated serum CA125 levels. (3) Among the 12 patients, 8 young infertile patients who needed to preserve their reproductive function underwent appendectomy, 3 infertile patients underwent staged surgery for ovarian malignant germ cell tumor, and only one bilateral lesion and infertile patient underwent unsatisfactory staged surgery for ovarian malignant germ cell tumor. Of the 12 patients, 11 patients were given combined chemotherapy regimen of bleomycin, cisplatin, and etoposide (BEP) after operation. One patient without chemotherapy developed metastasis 3 months after operation, and was given BEP chemotherapy, and her condition was controlled. (4) The deadline for follow-up was December 31st, 2022, and the median follow-up time was 60 months (range: 25-115 months). All the 12 patients survived without tumor during the follow-up period, and the median disease-free survival time was 84.5 months (range: 25-115 months). Conclusions: OYST mostly occurs in children and young women. Color Doppler ultrasound examination and serum AFP and CA125 detection have diagnostic value for OYST. Surgical treatment after diagnosis of OYST includes surgery to preserve reproductive function and timely and standardized chemotherapy after operation. The prognosis of patients is good regardless of stage.
目的： 探讨卵巢卵黄囊瘤（OYST）的诊断、治疗及预后。 方法： 收集2013年1月至2020年12月青岛大学附属医院收治的12例OYST患者的临床病理资料及随访资料进行回顾性分析，总结OYST的诊断、治疗及预后。 结果： （1）12例OYST患者的中位年龄为20岁（范围：11~37岁）；首次就诊时12例患者均有盆腔包块；就诊原因：6例腹胀、腹痛，4例扪及下腹部包块，1例阴道流血，1例因阑尾炎就诊后发现；国际妇产科联盟（FIGO）2014分期：Ⅰa期4例、Ⅰc期2例、Ⅱc期1例、Ⅲc期4例、Ⅳb期1例。（2）12例患者术前均行彩超检查，其中10例提示单侧附件包块、2例提示双侧附件包块；中位肿瘤最大径为16.5 cm（范围：6.0~28.0 cm）。12例患者的术前甲胎蛋白（AFP）水平（均>1 210 μg/L）均明显高于正常值（<25 μg/L），11例有癌抗原125（CA125）检测结果的患者中9例血清CA125水平升高。（3）12例患者中，8例年轻未生育需保留生育功能者行患侧附件切除术；3例无生育要求者行卵巢恶性生殖细胞肿瘤分期手术；仅1例双侧病变、无生育要求者为Ⅳb期，肿瘤广泛转移，无法完成满意的分期手术。12例患者中，11例术后及时给予博来霉素+顺铂+依托泊苷（BEP）方案化疗；1例未化疗者术后3个月出现腹腔转移，给予BEP方案化疗，病情得到控制。（4）随访截止时间为2022年12月31日，中位随访时间为60个月（范围：25~115个月）；12例患者随访期内均无瘤生存，中位无瘤生存时间为84.5个月（范围：25~115个月）。 结论： OYST多发生于少年儿童及年轻女性，彩超检查及血清AFP和CA125检测对OYST有诊断价值。OYST诊断后给予手术治疗（包括保留生育功能手术）及术后及时、规范的化疗，无论分期，患者的预后均良好。.