Fertility-Sparing Strategies for Borderline Ovarian Tumors Based on Molecular Classification: From Bench to Bedside

交界性卵巢肿瘤(borderline ovarian tumors, BOTs)是一类具有独特生物学特征的卵巢肿瘤，好发于育龄期女性。虽然保留生育功能手术(fertility-sparing surgery, FSS)已成为这类患者的首选治疗方式，但由于BOTs仍具有恶性转化和转移的潜在风险，临床决策面临重大挑战。目前尚缺乏可靠的生物标志物来预测BOTs向低级别浆液性癌(low-grade serous carcinoma, LGSC)的进展风险，这使得临床医生在平衡肿瘤安全性和生育力保护时面临困境。BOTs显著的生物学异质性进一步增加了手术方式选择、辅助治疗决策和随访策略制定的复杂性。本文系统综述了当前BOTs分子分型研究的最新进展，旨在为临床实践提供更精准的决策依据，并为未来研究方向提供新的思路。Borderline ovarian tumors (BOTs) constitute a distinct category of ovarian neoplasms with unique biological characteristics, primarily affecting women of reproductive age. While fertility-sparing surgery (FSS) has become the preferred therapeutic strategy for these patients, clinical management remains challenging due to the potential risks of malignant transformation and metastasis. Currently, reliable biomarkers for predicting the progression risk of BOTs to low-grade serous carcinoma (LGSC) remain elusive, posing a therapeutic dilemma in balancing oncological safety and fertility preservation. The significant biological heterogeneity of BOTs further complicates surgical approach selection, adjuvant therapy decisions, and follow-up strategy formulation. This review systematically summarizes recent advances in molecular classification of BOTs, aiming to provide more precise evidence for clinical decision-making and offer new perspectives for future research directions.