卵巢子宫内膜异位症恶变与卵巢癌的相关性研究及预后分析  

Ovarian Carcinoma Transformed from Endometriosis:A Retrospective Analysis

作　　者：吴雨珂[1] 廖光东[1] 张竹[1] 杨帆[1] 赵倩颖[1] 何艳梅[1] 陈悦[1] 王平[1] 刘辉[1] 王红静[1] 郄明蓉[1] 

机构地区：[1]四川大学华西第二医院,四川成都610041

出　　处：《实用妇产科杂志》2014年第9期703-707,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的：探讨不同原因所致卵巢癌,尤其是是否由卵巢子宫内膜异位症（EMT）恶变而来的卵巢癌的临床病理及预后特征。方法：纳入2006年1月至2011年8月在四川大学华西第二医院病理检查确诊的有随访资料（术后随访时间2-89月）的EMT恶变者所致原发性卵巢癌患者49例为EMT恶变组,其病理类型为透明细胞癌、子宫内膜样腺癌及混合性腺癌;另选择非EMT恶变所致卵巢癌并与EMT恶变者具有相同组织学类型的卵巢癌患者188例为非EMT恶变组,比较两组卵巢癌的临床病理特征及预后特征。结果：1与非EMT恶变组比较,EMT恶变组在〈40岁人群中所占比例较大、CA125更多表现为正常而非升高、FIGO分期早期病例比例更多、透明细胞癌及子宫内膜样腺癌这两种病理类型的比例较高,两组差异有统计学意义（P〈0.05）。2单因素预后分析：EMT恶变所致透明细胞癌的生存率明显高于非EMT恶变所致透明细胞癌（P=0.010）,是否由EMT恶变对子宫内膜样腺癌及混合性腺癌的预后影响不确切（P〉0.05）。3多因素COX回归分析：EMT恶变、手术满意度及FIGO分期是影响预后的独立危险因素。结论：EMT恶变所致卵巢癌病理类型主要包括透明细胞癌和子宫内膜样腺癌,EMT恶变是卵巢癌预后的独立影响因素,EMT恶变患者年龄相对较年轻、FIGO分期相对较早,尤其对透明细胞癌而言,EMT恶变的患者可能拥有更好的预后。Objective：To evaluate the correlation of the clinical characteristics and prognosis of ovarian carcinoma（OC）caused by different reasons, especially those transformed from ovarian endometriosis（EMT）. Methods：49 cases of OC transformed from EMT（group A）and 188 cases of OC nottransformed from EMT（group B） who were diagnosed in the West China Second Hospital, Sichuan University during January 2006 to August 2011 were included. The subtypes in the group A included clear cell, endometrioid,serous and mixed OC, and the subtypes in group B was consistent with group A. The follow-up period were 2 -89 months. The clinical characteristics and prognosis between the two groups are compared. Results： ①The patients in group A were more likely to have younger age,lower CAI2s level, and earlier FIGO stage. The main subtypes in group A were endometrioid and clear cell carcinoma. ②Univariate analysis showed that the patients of clear cell carcinoma in group A had a better overall survival than group B（ P =0. 010）, but no difference was observed in patients of endometrioid carcinoma or mixed ovarian carcinoma. ③Multivariate survival analysis showed that the surgical resection degree, EMT transformation,and FIGO staging were independent prognostic factors of OC. Conclusions：The main subtypes in EMT-transformed OC were endometrioid and clear cell carcinoma,and EMT transformation was an independent prognostic factor of ovarian carcinoma. The EMT-transformed patients seemed to have a better survival rate.

关 键 词：卵巢子宫内膜异位症 恶变 卵巢癌 透明细胞癌 预后 

分 类 号：R737.31[医药卫生—肿瘤]