卵巢子宫内膜异位症恶性变25例临床分析

Clinical Analysis of 25 Cases of Malignant Transformation of Endometriosis of the Ovary

目的 探讨卵巢子宫内膜异位症恶性变的临床表现、病理特征、治疗方法和预后。方法 回顾性分析 2 5例卵巢子宫内膜异位症恶性变患者的临床和病理资料。结果 卵巢子宫内膜异位症恶性变患者的主要症状为盆腔包块、腹胀、腹痛、异常阴道流血和流液。病理类型为子宫内膜样癌14例 ,透明细胞癌 2例 ,腺棘癌 2例 ,浆液性腺癌 1例 ,混合性卵巢上皮性癌 6例 ,镜下均可见良性的异位子宫内膜向恶性移行的证据。临床分期为Ⅰ期 14例 ,Ⅱ期 7例 ,Ⅲ期 3例 ,Ⅳ期 1例。治疗方法均采用肿瘤细胞减灭术 +化学治疗。患者 5年生存率达 77 7%。结论 卵巢子宫内膜异位症恶性变的确切发生率难以估计 ,该病的治疗以肿瘤细胞减灭术 +化学治疗为主。

Objective To study clinicopathologic characteristics, treatment and prognostic factors of malignant transformation of endometriosis of the ovary. Methods From 1981 to 1999, a total of 25 patients with malignant transformation of endometriosis of the ovary were retrospectively analyzed. Results The main symptoms were pelvic masses,abdominal pain, abdominal distension and abnormal vaginal bleeding or discharge. Histological type: of the 25 cases, 14 were endometrioid carcinomas, 2 were clear cell carcinomas, 2 were adenoacanthoma, 1 was serous papillary adenocarcinomas, 6 were mixed epithelium tumor of ovary. The exact area of histologic transition from benign to malignant epithelium was observed in 25 patients. Stage: stage Ⅰ 14, stage Ⅱ 7, stage Ⅲ 3, stage Ⅳ 1. The actual 5 year survival rate was 77 7%. Conclusions The exact incidence and prevalence of malignant transformation in endomrtriosis is unknown. Radical tumor resection combined with chemotherapy is the main therapeutic approach for malignant transformation of endometriosis of the ovary.