卵巢子宫内膜异位症恶变26例临床病理分析

Clinicopathological features of malignant ovarian neoplasms arising from ovarian endometriosis: a report of 26 cases

目的 探讨卵巢子宫内膜异位症 (内异症 )恶变的临床病理特征。方法 回顾分析 2 6例卵巢内异症恶变患者的临床和病理资料。结果 患者以痛经和检查发现盆腔肿块为主要临床表现。行B超或彩色多普勒超声检查者 18例 ,其中 10例发现盆腔肿块中含实质性结构。肿瘤组织类型以内膜样腺癌和透明细胞癌常见。 5 8% ( 15 2 6)患者的肿瘤显微镜下可见不典型内异症。国际妇产科联盟分期 :Ⅰ期 2 1例 ( 81% ) ,Ⅱ期 3例 ( 12 % ) ,Ⅲ期 2例 ( 8% )。结论 卵巢内异症恶变早期临床诊断存在困难 ,B超或彩色多普勒超声检查有重要参考价值。重视观察异位内膜组织形态变化 ,有利于认识卵巢内异症恶变的发生和发展过程 ,提高诊断和治疗水平。

Objective To clarify the features of malignant ovarian neoplasms arising from ovarian endometriosis Methods A total of 26 women with malignant ovarian neoplasms arising from ovarian endometriosis were analyzed retrospectively Results Dysmenorrhea and pelvic mass were the most common clinical features Among 18 cases who underwent B ultrasound or color doppler ultrasound examination, solid foci in the pelvic masses were found in 10 cases The main histologic types of ovarian malignancy were endometrioid adenocarcinoma and clear cell carcinoma Microscopically atypical endometriosis with the tumors were found in 15 cases International Federation of Gynecology and Obstetrics stage:stage Ⅰ 21(81%)cases,stage Ⅱ 3(12%)cases,stage Ⅲ 2 (8%)cases Conclusions Clinical diagnosis of malignant ovarian neoplasms arising from ovarian endometriosis in early stage is difficult, and B ultrasound examination is more valuable for diagnosis It is suggested that close serutiny of endometrial hyperplasia, cellular atypia and malignancy in ovarian endometriosis be essential to understand the origin and development of malignant neoplasms arising from ovarian endometriosis