探讨卵巢交界性浆黏液性肿瘤(OSMBT)的临床病理学特征、诊断和鉴别诊断，并进行文献复习。

选择2005—2017年，于北京市石景山医院进行手术治疗的4例OSMBT患者(患者1～4)为研究对象。采用回顾性分析方法，收集这4例患者的临床病例资料，对其临床病理学特征、诊断要点进行分析。本研究对OSMBT相关文献进行复习，设定文献检索策略为：以"卵巢肿瘤""浆黏液性肿瘤""交界性肿瘤""ovarian neoplasm""seromucinous neoplasm"及"borderline neoplasm"为关键词，在万方数据知识服务平台、中国知网数据库及PubMed数据库中，检索OSMBT相关文献，检索时间设定为2010年1月1日至2019年1月31日。总结OSMBT的临床病理学特点、诊断要点。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。

①4例OSMBT患者的一般临床资料：发病年龄为29～65岁，中位年龄为40岁；主要临床表现为腹痛和盆腔包块；国际妇产科联盟(FIGO)分期均为Ⅰ期。手术方式：对患者1、2进行卵巢囊肿剔除术，患者3、4进行全子宫及双侧附件切除术。手术切除标本的大体观察：肿瘤直径为0.9～10.0 cm，平均为4.4 cm；患者2肿瘤发生于双侧卵巢；患者1～3肿瘤呈单房囊性(囊壁内可见乳头状结构)，患者4肿瘤呈实性。手术切除标本的活组织病理学检查结果：肿瘤囊壁衬覆分支乳头状结构，无间质浸润。肿瘤上皮细胞内、乳头状结构的间质内和肿瘤性腺体的腺腔内，均可见明显中性粒细胞浸润。乳头被覆上皮细胞复层排列，主要由宫颈管型黏液性上皮、浆液性上皮、嗜酸性细胞组成。细胞核呈轻、中度异型性，核分裂象少见。患者2伴发子宫内膜异位症。手术切除标本的免疫组化结果：免疫表型CK7、PAX8呈阳性，CK20、CDX2呈阴性。随访结果：对4例患者于术后随访15～156个月，平均为78.8个月，均未发现OSMBT复发或转移。②文献复习结果：共计筛选出9篇OSMBT相关文献，涉及OSMBT患者为86例。其主要临床表现为腹胀、腹痛、下腹不适等，中位年龄为49岁；肿瘤平均直径为7.9 cm；19.1%(13/68)患者肿瘤发生于双侧卵巢；34.9%(30/86)患者伴有子宫内膜异位症；91.2%(62/68)患者FIGO分期为Ⅰ期。8篇文献报道对66例患者的平均随访时间为35.9个月，OSMBT复发率为6.1%(4/66)。

OSMBT临床较少见，多见于较年轻女性，其发生主要与子宫内膜异位症相关。临床对该病的诊断主要根据手术切除标本的活组织病理学检查和免疫组化检测结果，需注意与卵巢交界性浆液性、黏液性肿瘤及癌的鉴别诊断。OSMBT患者多为FIGO Ⅰ期，预后良好。对于需保留生育功能的年轻OSMBT患者，可采取卵巢囊肿剔除术治疗，并且术后需密切随访。

To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of ovarian seromucinousborderline tumors (OSMBT), and review the related literature.

From 2005 to 2017, a total of 4 patients with OSMBT who underwent surgery at Beijing Shijingshan Hospital were selected as research subjects. The clinical data of the patients were collected by retrospective analysis method and the clinicopathological features, diagnosis of the patients were summarized. With the following keywords of " ovarian neoplasm" " seromucinous neoplasm" and " borderline neoplasm" both in Chinese and English, literature related to OSMBT were searched from Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure database and PubMed database, and literature retrieval time was set from January 1 of 2010 to January 31 of 2019. Clinicopathological features and diagnosis of OSMBT in searched literature were summarized. This study was in line with the requirement of World Medical Association of Helsinki revised in 2013.

①The results of 4 patients with OSMBT in this study were as follows. General clinical data: the patients′ age were from 29 to 65 years old, with a median age of 40 years old. The major clinical manifestations included abdominal pain and masses in pelvic cavity. The stages of International Federation of Gynecology and Obstetrics (FIGO) of 4 patients all were stage Ⅰ. Surgical methods: patient 1 and 2 underwent ovarian cystectomy, and patient 3 and 4 underwent hysterectomy and bilateral salpingo-oophorectomy. Appearance observation of surgically removed specimens: the tumors of 4 patients ranged in diameter from 0.9-10.0 cm, and the average diameter of these tumors was 4.4 cm. Patient 2 was bilateral OSMBT. The masses of tumors were described as unilocular cyst with papillary architecture in patient 1 to 3, and as solid in patient 4. Histopathological results of surgically removed specimens: the OSMBT tissues showed complex branched papillary architecture, without stromal invasion. Significant neutrophil infiltration was observed in the tumor epithelium, stroma of papillary architecture and glandular lumen of tumor gland. The lining epithelium was stratified and composed mostly of endocervical-type mucous, serous epithelium and hobnail cells with eosinophilic cytoplasm, and the nuclei were mild and moderately heterogeneous, and karyokinesis was rare. Patient 2 with bilateral OSMBT was combined with endometriosis. Immunohistochemisty results of surgically removed specimens: the immunophenotype of these tumor tissues exhibited CK7⁺ /PAX8⁺ /CK20^-/CDX2^-. Follow-up results: none OSMBT recurrence or metastasis was found in 15 to 156 months (average of 78.8 months) follow-up of all the 4 patients. ②The results of literature review were as follows. A total of 9 literature related with OSMBT were retrieved, involving 86 cases of OSMBT patients. The main clinical manifestations of them were abdominal distension, abdominal pain, abdominal discomfort, and so on. The median age of them was 49 years old. The average diameter of these tumors was 7.9 cm. Among them, 13 cases (19.1%, 13/68) were bilateral OSMBT, 30 cases (34.9%, 30/86) were accompanied with endometriosis, and 62 cases (91.2%, 62/86) were FIGO Ⅰstage. The average follow-up time was 35.9 months among 66 patients in 8 pieces of literature and the recurrence rate of OSMBT was 6.1% (4/66).

OSMBT is a kind of rare ovarian neoplasm and mainly associated with endometriosis. Most OSMBT patients are young. Histopathological detection results as well as immunohistochemical marker may help in pathologic diagnosis of OSMBT. Attention should be paid to the differential diagnosis from ovarian borderline serous, mucinous tumor and carcinoma before final diagnosis. Most patients with OSMBT are FIGO Ⅰ stage and have a good prognosis. Unilateral oophorectomy and follow-up closely could be a valid proposal in young patients who wish to preserve their fertility.