原发性卵巢透明细胞癌预后因素分析

Prognostic factors of primary clear cell carcinoma of the ovary

目的 卵巢透明细胞癌在卵巢恶性肿瘤中相对罕见。本研究通过对40例卵巢透明细胞癌患者临床资料及预后进行回顾性分析,探讨卵巢透明细胞癌患者临床特征及预后影响因素。方法 收集安徽医科大学附属省立医院妇产科2010-01-01-2017-06-30收治的40例卵巢透明细胞癌患者临床资料,并对患者或家属以电话或短信方式随访,采用Kaplan-Meier曲线进行生存分析,Log-rank检验分析组间生存率差异,Cox回归分析模型筛选影响卵巢透明细胞癌独立因素。结果 40例患者1年生存率为87.5%,3年生存率为64.0%。单因素分析结果显示,患者总生存时间的中位生存时间与FIGO分期(χ2=14.282,P<0.001)、是否合并子宫内膜异位症(χ2=6.193,P=0.013)、是否满意减瘤(χ2=23.121,P<0.001)、有无淋巴结转移(χ2=5.021,P=0.025)、病灶累及单双侧卵巢(χ2=10.56,P=0.001)和化疗周期数(χ2=6.059,P=0.014)有关联;多因素分析结果显示,FIGO分期、是否满意减瘤及病灶侵及单侧或双侧卵巢是影响生存预后的独立因素。结论 FIGO分期较早、减瘤术满意及化疗满周期能明显改善原发性卵巢透明细胞癌患者的预后,早诊断、早治疗、术中尽可能做到满意减瘤及术后辅以正规足周期的化疗是提高原发性卵巢透明细胞癌生存率的关键。

OBJECTIVE To investigate the clinical characteristics and prognostic factors of ovarian clear cell carcinoma(OCCC)by retrospectively analyzing the clinical data and prognosis of 40patients with OCCC,due to the ovarianclear cell carcinoma is relatively rare in ovarian malignancies.METHODS The clinical data of 40cases of ovarian clear cellcarcinoma treated in the Department of Gynecology and Obstetrics of the Affiliated Provincial Hospital of Anhui MedicalUniversity from the January 1th 2010to June 31th 2017were collected.The patients or their families were followed up bytelephone or text message.The survival analysis was carried out by Kaplan-Meier curve.Log-rank was used to examine thedifference of survival rate between groups,and Cox regression model was used to screen independent factors affecting ovarian clear cell carcinoma.RESULTS The 1-year survival rate and the 3-year survival rate of the 40patients were 87.5%and 64.0%.Univariate analysis showed that the median survival time of total survival time was associated with FIGOstaging(χ2=14.282,P<0.001),endometriosis(χ2=6.193,P=0.013),satisfactory tumor reduction(χ2=23.121,P<0.001),lymph node metastasis(χ2=5.021,P=0.025),lesions involving single and double ovaries(χ2=10.56,P=0.001)and chemotherapy cycles(χ2=6.059,P=0.014)were significantly different;Cox analysis showed that FIGO staging,satisfactory tumor reduction and unilateral or bilateral ovarian involvement were independent predictors of survival and prognosis.CONCLUSIONS Early FIGO staging,satisfactory tumor reduction and full-cycle chemotherapy can significantly improve the prognosis of patients with primary clear cell ovarian cancer.Early diagnosis,early treatment,satisfactory tumorreduction during operation and postoperative full-cycle chemotherapy are the key to improve the survival rate of primaryclear cell ovarian cancer.