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目的:探讨运用临床指标预先判断儿童卵巢肿瘤良恶性对选择手术方案的参考价值。方法:收集2010年1月至2019年10月上海交通大学医学院附属新华医院收治行手术治疗的166例卵巢占位患儿的临床资料。患儿手术年龄为（6. 03±4. 24）岁；146例为良性肿瘤，作为良性组，手术年龄为（6. 00±4. 22）岁，78. 1 %（114/146）的患儿有临床症状；20例为恶性肿瘤，作为恶性组，手术年龄为（6. 40±3. 67）岁，95. 0%（19/20）的患儿有临床症状。对患儿基本信息、流行病学资料、临床表现、肿瘤标志物、肿瘤影像学检查结果（包括肿瘤直径和占位性质）、实验室指标、肿瘤良恶性以及最终病理诊断结果进行分析、比较。结果:患儿均接受了开放或腹腔镜下单纯肿瘤剥除术或肿瘤及同侧卵巢、附件切除术。其中，急诊手术31例，择期手术135例；保留卵巢手术84例，切除患侧卵巢手术82例。①影像学检查提示实质性占位16例[9. 6% （16/166）]，囊实性占位87例[52. 4% （87/166）]，囊性占位60例[36. 1%（60/166）]，另有3例[1. 8%（3/166）]在术前未明确占位性质，恶性肿瘤术前影像学更多地表现为实性或囊实性。肿瘤直径为（7. 25±4. 78）cm，良性组肿瘤最大直径为（6. 34±3. 94) cm，恶性组为（13. 71±5. 40 ）cm，两组之间的差异具有统计学意义（n P8. 75 cm的患儿中，恶性18例，良性27例，差异具有统计学意义（n P<0. 001）。另外，未扭转卵巢肿瘤中恶性肿瘤直径也显著大于良性肿瘤，（13. 71±5. 40）cm比（8. 21±13. 56）cm，差异具有统计学意义（n P<0. 01）。②术前肿瘤标志物检测提示恶性肿瘤患儿血清甲胎蛋白（α-fetoprotein, AFP）、糖类抗原125 (carbohydrate antigen 125, CA125）和（或）乳酸脱氢酶（lactate dehydrogenase，LDH）水平明显上升。③病理诊断提示恶性组病理类型包括未成熟畸胎瘤、卵黄囊瘤、颗粒细胞瘤和无性细胞瘤。良性组病理类型包括成熟畸胎瘤、单纯囊肿、滤泡囊肿、浆液性囊腺瘤、黏液性囊腺瘤、黄体囊肿、海绵状血管瘤、间皮包涵囊肿和坏死卵巢。恶性组和良性组比较：良性组患儿有66例接受了卵巢切除术，43例患儿存在卵巢扭转且均为良性肿瘤（n R=-0. 222，n P=0. 002）。n 结论:术前卵巢占位患儿的相关影像学指标、肿瘤标志物对占位的良恶性评估有一定提示。“,”Objective:To explore the reference value of prejudging benign and malignant tumors by clinical parameters for selecting surgical options.Methods:From January 2010 to October 2019, clinical data were reviewed for 166 children with ovarian masses undergoing surgery. Operative age was (6. 03±4. 24) years; 146 benign tumors of benign group had an operative age of (6. 00±4. 22) years and 78. 1% (114/146) had clinical symptoms; 20 malignant tumors of malignant group had an operative age of (6. 40±3. 67) years and 95. 0% (19/20) had clinical symptoms. Basic profiles, epidemiological data, clinical manifestations, tumor markers, tumor imaging findings (including tumor diameter & mass nature) , laboratory parameters, benign and malignant tumors and final pathological diagnosis were compared.Results:All of them underwent open or laparoscopic simple tumor stripping or tumor and ipsilateral oophorectomy and adnexectomy. The procedures included emergency surgery (n=31) , elective surgery (n=135) , ovariectomy (n=84) and ovariectomy (n=82) . Imaging examinations revealed solid mass (n=16, 9. 6%) , cystic/solid mass (n=87, 52. 4%) , cystic mass (n=60, 36. 1%) and non-specific mass (n=3, 1. 8%) . Tumor diameter was (7. 25±4. 78) cm. Maximal tumor diameter was (6. 34±3. 94) cm in benign group and (13. 71±5. 40) cm in malignant group. The inter-group difference had statistical significance (n P8. 75 cm in diameter, 18 were malignant and 27 benign and the difference was statistically significant (n P<0. 001) . In addition, the diameter of malignant tumors in untwisted ovarian tumors was also significantly larger than that of benign tumors, (13. 71±5. 40) cm vs. (8. 21±13. 56 ) cm and the difference was statistically significant (n P<0. 01) . Preoperative tumor marker detection: serum alpha-fetoprotein (AFP) , CA125 and/or lactate dehydrogenase (LDH) levels were significantly elevated in children with malignant tumors. Pathological diagnosis revealed that pathological types of malignant group included immature teratoma, yolk sac tumor, granular cell tumor and dysgerminoma. The pathological types in benign group included mature teratoma, simple cyst, follicular cyst, serous cystadenoma, mucinous cystadenoma, luteal cyst, cavernous hemangioma, mesothelial inclusion cyst and necrotic ovary. Comparison of malignant and benign groups: 66 children in benign group underwent oophorectomy and all 43 children of ovarian torsion were benign tumors (n R=-0. 222, n P=0. 002) .n Conclusions:The relevant imaging parameters and tumor markers of children with preoperative ovarian masses may offer some hints for benign and malignant mass assessments.