原发性卵巢透明细胞癌70例预后因素分析

A clinical analysis and prognosis of 70 cases of primary ovarian clear cell carcinoma

目的 探讨卵巢透明细胞癌（OCCC）的临床特点和预后因素。方法 回顾性分析1984年1月至2010年12月间辽宁省肿瘤医院收治的70例原发性卵巢透明细胞癌患者临床资料,对其治疗情况进行总结并分析其预后。结果70例卵巢透明细胞癌患者中,〈50岁组34例,≥50组36例,两组5年生存率分别为35.29%、38.89%,差异无统计学意义（P=0.59）;FIGO分期中Ⅰ期30例（42.9%）,Ⅱ期6例（8.6%）,Ⅲ期29例（41.4%）,Ⅳ期5例（7.1%）。Ⅰ、Ⅱ期患者5年生存率分别为50.00%、33.33%,两者比较差异有统计学意义（P=0.03）,Ⅰ-Ⅱ期患者5年生存率47.20%,Ⅲ～Ⅳ期患者5年生存率26.40%,两者比较差异有统计学意义（P=0.01）。残余瘤〈1 cm组与残余瘤≥1 cm组5年生存率比较差异有统计学意义（P〈0.01）;铂类化疗组与非铂类化疗组5年生存率分别为27.27%、38.98%,差异无统计学意义（P=0.08）。在单变量分析中,FIGO分期、残余瘤大小是影响预后的因素,多变量分析亦表明分期及残余瘤大小是影响预后的独立因素。结论 卵巢透明细胞癌患者的预后与分期及残余瘤大小有关,该病理类型有高侵袭性的生物学行为,预后差。

Results There were 34 patients under 50 years old of the 70 cases,and 36 patients more than 50 years old.The 5-year survival rates of two groups were 35.29% and 38.89% respectively,the difference being not statistically significant （P = 0.59）. According to FIGO staging, stage Ⅰ had 30 patients （42.9%）,and stage Ⅱ had 6 cases （8.6%）, stage Ⅲ 29 cases （41.4%）, stage Ⅳ 5 cases （7.1%）. The 5-year survival rates of stage Ⅰ and Ⅱ patients were 50.00% and 33.33%,respec- tively,and the difference was statistically significant （P= 0.03）.The 5-year survival rate in stage Ⅰ- Ⅱ and stage Ⅲ-Ⅳ was 47.20% and 26.40%,respectively,the difference being statistically significant （P= 0.01）. The 5-year survival rate difference between the group of residual tumor 〈lcm and residual tumor~〉lcm was statistically significant（P〈0.01）;The 5- year survival rates in platinum-based chemotherapy group and non-platinum-based chemotherapy were 27.27% and 38.98%,respectively,the difference being not statistically significant （P=0.08）.In univariate analysis, FIGO stage and residual tumor size were prognostic factors;muhivariate analysis also showed that clinical stage and residual tumor size were independent prognostic factors.Condusion The prognosis of ovarian clear cell carcinoma is significantly related to FIGO stage and the size of the residual tumor;the pathological types have aggressive biological behavior and poor prognosis.