卵巢生殖细胞肿瘤是一种罕见且复杂的肿瘤,其特征是不同的组织学亚型。这篇全面的综述阐明了分类,诊断,治疗,预后,以及与这些肿瘤相关的独特挑战。分类植根于组织学属性,主要亚型包括无性细胞瘤,未成熟畸胎瘤,卵黄囊瘤(内胚窦瘤),绒毛膜癌,和混合生殖细胞肿瘤。每个亚型都有不同的特征和临床意义,需要精确的诊断和量身定制的治疗策略。诊断取决于识别广泛的临床表现,采用成像技术(如超声和MRI),评估肿瘤标志物(甲胎蛋白和β-人绒毛膜促性腺激素),并在必要时进行组织病理学检查。分期,主要利用国际妇产科联合会(FIGO)系统,是决定疾病程度的关键,指导治疗选择,并促进预后评估。治疗方式包括手术,化疗(包括标准方案和新兴疗法),放射治疗,靶向治疗,和免疫疗法。预后受组织学亚型的影响,肿瘤分期,患者年龄,手术成功,对化疗的反应,和肿瘤标志物,而预测性生物标志物不断涌现。尽管在治疗方面取得了进展,卵巢生殖细胞肿瘤提出了不同的挑战,包括晚期诊断,治疗相关的副作用,和化学抗性之谜。全面护理的一个组成部分是支持策略,以管理症状并提供心理和情感支持。这篇综述强调了早期诊断和多学科护理在优化预后中的重要作用。在这些复杂而独特的恶性肿瘤中探索未来的研究方向和不断发展的临床实践,突出卵巢生殖细胞肿瘤的动态景观。
Ovarian germ cell tumors constitute a rare and intricate spectrum of neoplasms characterized by diverse histological subtypes. This comprehensive review elucidates the classification, diagnosis, treatment, prognosis, and unique challenges associated with these tumors. The classification is rooted in histological attributes, with principal subtypes encompassing dysgerminoma, immature teratoma, yolk sac tumor (endodermal sinus tumor), choriocarcinoma, and mixed germ cell tumors. Each subtype bears distinct characteristics and clinical implications, necessitating precise diagnosis and tailored therapeutic strategies. Diagnosis hinges upon recognizing the broad clinical presentation, employing imaging techniques (such as ultrasound and MRI), evaluating tumor markers (alpha-fetoprotein and beta-human chorionic gonadotropin), and conducting histopathological examinations where necessary. Staging, primarily utilizing the International Federation of Gynecology and Obstetrics (FIGO) system, is pivotal in determining the extent of disease, guiding treatment choices, and facilitating prognostic assessment. Treatment modalities encompass surgery, chemotherapy (including standard regimens and emerging therapies), radiation therapy, targeted therapies, and immunotherapy. Prognosis is influenced by histological subtype, tumor stage, patient age, surgical success, response to chemotherapy, and tumor markers, while predictive biomarkers are continually emerging. Despite advances in treatment, ovarian germ cell tumors pose distinct challenges, including late diagnosis, treatment-related side effects, and the enigma of chemoresistance. An integral aspect of comprehensive care is supportive strategies to manage symptoms and offer psychological and emotional support. This review accentuates the vital role of early diagnosis and multidisciplinary care in optimizing outcomes. Future research directions and evolving clinical practices are explored in these intricate and distinctive malignancies, highlighting the dynamic landscape of ovarian germ cell tumors.