卵巢透明细胞癌和卵巢子宫内膜样癌患者的临床特症及预后分析  

Clinical characteristics and prognosis of patients with ovarian clear cell carcinoma and ovarian endometrioid carcinoma

作　　者：奚晓雪[1,2] 沈晨[3] 陈婷 曹天越 钱永红[1,2] 王慧玲 居颂文[4] 侯顺玉[1,2] XI Xiaoxue;SHEN Chen;CHEN Ting;CAO Tianyue;QIAN Yonghong;WANG Huiling;JU Songwen;HOU Shunyu(Department of Obstetrics and Gynaecology,The Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital,Suzhou,Jiangsu 215002,China;Gusu School,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Department of Obstetrics and Gynaecology,Suzhou Hospital of Traditional Chinese Medicine,Suzhou,Jiangsu 215003,China;Central Laboratory,The Affiliated Suzhou Hospital of Nanjing Medica University,Suzhou,Jiangsu 215128,China)

机构地区：[1]南京医科大学附属苏州医院/苏州市立医院妇产科,江苏苏州215002 [2]南京医科大学姑苏学院,南京211166 [3]苏州市中医医院妇产科,江苏苏州215003 [4]南京医科大学附属苏州医院中心实验室,江苏苏州215128

出　　处：《重庆医学》2023年第16期2499-2506,共8页Chongqing medicine

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2020028);南京医科大学姑苏学院科研项目(GSKY20210208)。

摘　　要：目的探讨卵巢透明细胞癌(OCCC)和卵巢子宫内膜样癌(OEC)患者的临床特征及预后。方法回顾性分析2013年1月1日至2018年8月31日在南京医科大学附属苏州医院初次诊治的156例卵巢上皮癌患者临床资料。根据病理结果将患者分为OCCC组(n=61)和OEC组(n=95),比较两组的一般资料、临床表现、辅助检查、手术及术后随访信息。随访时间至2022年8月31日,采用COX比例风险模型进行预后影响因素的单因素和多因素分析。结果OCCC组年龄明显大于OEC组(P<0.05),绝经患者占比明显高于OEC组(P<0.05)。OCCC组合并腹水及有淋巴结转移患者占比明显高于OEC组(P<0.05)。OCCC组与OEC组国际妇产科联盟(FIGO)分期及肿瘤分化程度分布比较,差异均有统计学意义(P<0.05)。OCCC组总生存期(OS)明显短于OEC组(28.4个月vs.37.9个月,χ^(2)=4.443,P=0.035)。COX多因素分析显示,卵巢癌患者OS与合并子宫内膜异位症、FIGO分期及化疗耐药相关(P<0.05)。结论OCCC与OEC虽均为子宫内膜异位症相关卵巢癌,但临床特征及预后存在较多差异。Objective To investigate the clinical characteristics and prognosis of patients with ovarian clear cell carcinoma(OCCC)and ovarian endometrioid carcinoma(OEC).Methods The clinical data of 156 patients with epithelial ovarian cancer,who were initially diagnosed and treated in the Affiliated Suzhou Hospital of Nanjing Medical University from January 1,2013,to August 31,2018,were retrospectively analyzed.According to the pathological results,the patients were divided into two groups:the OCCC group(n=61)and OEC group(n=95).The general information,clinical manifestations,auxiliary examinations,and surgical procedures and postoperative follow-up information were compared between the two groups.The patients were followed up till August 31,2022.The COX proportional risk model was applied for univariate and multivariate analysis of prognostic factors.Results The age of patients in the OCCC group was significantly larger than that in the OEC group(P<0.05),and the proportion of menopausal patients was significantly higher than that in the OEC group(P<0.05).The percentages of patients with ascites and lymph node metastasis in the OCCC group were significantly higher than those in the OEC group(P<0.05).There were statistically significant differences in the distribution of International Federation of Gynecology and Obstetrics(FIGO)staging and tumor differentiation between the OCCC group and OEC group(P<0.05).The overall survival(OS)of the OCCC group was significantly shorter than that of the OEC group(28.4 months vs.37.9 months,χ^(2)=4.443,P=0.035).COX multivariate analysis showed that OS in patients with ovarian cancer was associated with endometriosis,FIGO stage,and chemotherapy resistance(P<0.05).Conclusion Although both OCCC and OEC are ovarian cancers related to endometriosis,there are significant differences in their clinical features and prognosis.

关 键 词：卵巢透明细胞癌 卵巢子宫内膜样癌 卵巢上皮癌 预后 生存分析 

分 类 号：R737.31[医药卫生—肿瘤]