子宫内膜异位症相关卵巢上皮癌的临床及预后特征分析

Clinical and Prognostic Characteristics of Ovarian Epithelial Carcinoma with Ovarian Endometriosis

目的:探究子宫内膜异位症相关卵巢癌(endometriosis-associated ovarian cancer,EAOC)的临床及预后特征。方法:选取2004年1月—2017年7月于大连市妇幼保健院就诊并接受手术的卵巢上皮癌[透明细胞癌(ovarian clear cell carcinoma,OCCC)和子宫内膜样癌(ovarian endometrioid carcinoma,OEC)]患者139例,根据是否合并卵巢子宫内膜异位症(endometriosis,EMs)分为EAOC组(41例)及non-EAOC组(98例),回顾性分析其临床资料并随访预后情况。结果:EAOC组患者年龄、初潮年龄小于non-EAOC组(均P<0.05)。EAOC组未绝经患者比例高于non-EAOC组(χ~2=5.806,P=0.023)。EAOC组孕次少于non-EAOC组(χ~2=3.206,P=0.001)。EAOC组患者痛经及月经紊乱发生率多于non-EAOC组(均P<0.05)。non-EAOC组患者腹部不适多于EAOC组患者(χ~2=6.645,P=0.013)。2组患者血清CA-125值、包块最大直径比较差异无统计学意义(均P>0.05)。EAOC组与non-EAOC组患者FIGO分期分布不同(χ~2=2.497,P=0.013)。EAOC组的5年生存率大于non-EAOC组(χ~2=4.304,P=0.038)。2组患者Log rank分析χ~2=4.916,P=0.028。结论:卵巢EAOC患者较单纯型卵巢上皮癌患者具有年龄及初潮年龄小、未绝经比例高、孕次少、痛经和月经紊乱症状明显、分期较早及预后较好等特征。

Objective:To investigate the clinical and prognostic characteristics of endometriosis-associated ovarian cancer(EAOC). Methods:One hundred and thirty-nine patients with epithelial ovarian cancer [ovarian clear cell carcinoma(OCCC) and ovarian endometrioid carcinoma(OEC)] who were treated and operated in Dalian Maternity Hospital from January2004 to July 2017 were selected according to whether they were complicated with ovarian endometriosis(EMs) were divided into EAOC group(41 cases) and the other into non-EAOC group(98 cases), the clinical data were retrospectively analyzed and follow-up prognosis. Results:The onset age and the age of menarche in EAOC group were lower than those in non-EAOC group(all P<0.05). The proportion of non-menopausal patients in EAOC group was higher than that in non-EAOC group( χ~2=5.806,P=0.023). The distribution of pregnancy was different, EAOC group was lower than non-EAOC group( χ~2=3.206, P=0.001). The incidence of dysmenorrhea and menstrual disorders in EAOC group was higher than that in non-EAOC group(all P <0.05).Patients with non-EAOC had more abdominal discomfort than patients with EAOC( χ~2=6.645, P =0.013). There was no significant difference between the two groups in the serum CA-125 value and the maximum diameter of the mass(all P>0.05).The FIGO staging distribution was different in patients with EAOC and non-EAOC( χ~2=2.497, P=0.013). The 5-year survival rate of EAOC group was higher than that of non-EAOC group( χ~2=4.304, P=0.038). Two groups of patients Log rank analysis( χ~2=4.916, P=0.028). Conclusions:Ovarian EAOC patients compare to simple ovarian epithelial cancer patients have the lower diagnosed age and lower age of menarche, the higher proportion of non-menopause, lower birth rate, dysmenorrhea and obvious menstrual disorders, earlier FIGO stage and better prognosis.