To establish the safety and quality of ovarian cortex surrounding epithelial ovarian tumors in women eligible for fertility-sparing surgery by identifying occult malignant lesions and characterizing the ovarian follicle pool. Multicentric retrospective study of 48 subjects (15–45 years), diagnosed with borderline ovarian tumors (BOTs) or early-stage epithelial ovarian cancers (EOCs) and eligible for fertility-sparing surgery. Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool, find any occult malignant lesion using tumor-specific markers (cytokeratin 7 and mucin 1), and quantify tumor-infiltrating lymphocytes (TILs) by CD3 and tumor associated macrophages (TAMs) by CD68. Occult ovarian lesions were observed in 6 out of 45 cases investigated (14.6%), including one mucinous stage-I BOT (1/14), one serous stage-I BOT (1/13), 3 advanced-stage serous BOTs (3/11) and one early-stage serous EOC (1/7). Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors compared to controls ( < 0.001) and at a younger age. Significantly higher follicle atresia was encountered in the ovarian tumor group then in controls (20.1 ± 8.8% vs 9.2 ± 9.4%, p < 0.001) at all ages. Both TILs and TAMs were found in ovarian tumors irrespective of histotype, but no link was established with the status of the ovarian reserve. Personalized counseling for fertility preservation is required in the event of BOTs and early-stage EOCs. Fertility-sparing surgery and adjuvant gamete preservation should be considered, balancing the oncological risks according to tumor stage and histotype and fertility potential, especially at a younger age.

中文翻译：

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诊断患有上皮交界性和早期恶性卵巢肿瘤的年轻女性残余卵巢皮质的生育潜力和安全性评估

通过识别隐匿性恶性病变和描述卵巢卵泡池的特征，确定适合接受保留生育手术的女性上皮性卵巢肿瘤周围卵巢皮质的安全性和质量。对 48 名受试者（15-45 岁）进行的多中心回顾性研究，这些受试者被诊断患有交界性卵巢肿瘤 (BOT) 或早期上皮性卵巢癌 (EOC)，并且有资格接受保留生育能力手术。对肿瘤周围卵巢皮质的组织学样本进行分析，以表征卵泡池，使用肿瘤特异性标记物（细胞角蛋白 7 和粘蛋白 1）发现任何隐匿的恶性病变，并通过 CD3 和肿瘤相关巨噬细胞 (TAM) 量化肿瘤浸润淋巴细胞 (TIL) ）由CD68。45例中，6例（14.6%）发现卵巢隐匿性病变，其中粘液性I期BOT 1例（1/14），浆液性I期BOT 1例（1/13），晚期浆液性BOT 3例（3例）。 /11) 和 1 例早期浆液性 EOC (1/7)。值得注意的是，与对照组相比（<0.001）且年龄较小，诊断为卵巢肿瘤的受试者的卵泡密度显着较低。在所有年龄段，卵巢肿瘤组的卵泡闭锁率均显着高于对照组（20.1 ± 8.8% vs 9.2 ± 9.4%，p < 0.001）。无论组织型如何，TIL 和 TAM 均在卵巢肿瘤中发现，但与卵巢储备状态没有联系。在 BOT 和早期 EOC 情况下，需要针对生育力保留的个性化咨询。应考虑保留生育能力的手术和辅助配子保存，根据肿瘤分期、组织型和生育潜力平衡肿瘤风险，尤其是在较年轻的年龄。