子宫内膜异位症与卵巢癌的关系

Prognosis of Patients with Ovarian Carcinoma Associated with Pelvic Endometriosis

目的：探讨子宫内膜异位症和卵巢癌两者的相互关系。方法：回顾性分析2003年1月～2005年1月间在复旦大学附属中山医院治疗的137例卵巢癌患者的临床资料。结果：137例卵巢癌患者合并子宫内膜异位症为37例(27%),肿瘤大小约5～15 cm。76.2%为单侧肿块。37例子宫内膜异位症合并卵巢癌患者的病理类型为卵巢内膜样癌(50.6%)、卵巢透明细胞癌(31.2%)、浆液性癌(13.3%)及其他(4.9%)。小于50岁的卵巢癌合并子宫内膜异位症的患者16例,发生率为43.2%：而大于50岁的此类患者10例。发生率为27.0%。绝经状态与发生率无明显关系(分别为13.3%和15.9%)。30例首次手术行肿瘤细胞减灭术,4例复发后转来我院再行肿瘤细胞减灭术。60%的患者均切除干净或基本切除。95%的患者进行了以铂类或紫杉醇为基础的联合化疗,其中90%的患者用化疗6疗程或以上。随访中,采用B超结合CA125的测定,特异性为57.9%。结论：随着子宫内异症发病率的增加,应高度重视其恶变问题。,临床工作中,对子宫内异症的患者要早诊断、早治疗,B超筛查结合CA125的定量测定有助于及时发现子宫内异症的恶变倾向。

Objective：To summarize the relationship between the pelvic endometriosis and the ovarian caricinoma. Methods ：137 cases with ovarian carcinoma from Jan. 12003 to 2005 were analyzed retrospectively. Results：Among 37 cases,endomtfiod carcinoma and clear cell carcinoma were most frequently associated with endometriosis, with 18 cases and 11 cases respectively. There were 16 cases ,who 〈50y （45%） and 10 cases ,who 〉50y （28%） . There were no significantly incidence of the menopause women. Drug therapy is recommended for endomtfisis after the operation. In the treatment of endomtriod carcinoma , Taxol and DDP can he used as an accessory method. Condiusion：Patients having ovarian carcinoma with pelvic endometriosis have a better prognosis than those without endometriosis. There is a close relationship between endometriosis and ovarian endometriod carcinoma and clear carcinoma, the malignant transformation of endometriosis loci may be an important origin of them.