子宫内膜异位症与特定类型的卵巢癌发生风险的相关性研究

The Study of Association Between Endometriosis and Risk of Certain Types of Ovarian Cancer

目的研究分析子宫内膜异位症与其特定类型的卵巢癌风险的相关性。方法收集我院2009年1月至2013年10月住院的子宫内膜异位症患者148例,其中单纯诊断为子宫内膜异位症141例,设为A组;另取同期未合并子宫内膜异位症的已确诊为卵巢癌的患者74例,设为B组;内异症合并有卵巢癌的患者7例,设为C组;健康体检者70例,设为D组。根据患者年龄,各组又分为绝经前和绝经后两部分,检测各组血清HE4、CA125、CA199等,计算ROMA指数。结果绝经前、后患者中四组两两比较CA125、HE4、CA199均有统计学差异(P<0.01);绝经前单纯内膜异位症较健康组肿瘤标志物检测升高,ROMA风险评估显示:子宫内膜异位症与卵巢癌的发生有相关性;内异症合并卵巢癌患者各项指标检测高于单纯内异症,但要低于单纯卵巢癌患者组,且有可能发生卵巢肿瘤。绝经前合并组与单纯卵巢癌患者比较ROMA无统计学差异(P>0.05)。所有单纯卵巢癌组与合并组比较:单纯卵巢癌组主要为III期,合并组患者主要为I期,与单纯卵巢癌组比较有差异(χ2=4.96,P<0.01)。单纯卵巢癌组与合并组比较,合并组发生透明细胞癌的比例较单纯卵巢癌组要高(χ2=8.59,P<0.01)。结论子宫内膜异位症有可能发生卵巢肿瘤,且主要与透明细胞癌相关,且子宫内膜异位症患者合并早期肿瘤比例较高,因此临床上可对子宫内膜异位症患者早期诊断及干预治疗。

Objective To analyze the association between endometriosis and risk of certain types of ovarian cancer. Methods 148 cases hospitalized in our hospital for endometriosis from January 2009 to October 2013 were collected,including group A of 141 cases patients with simple endometriosis,group B of 74 cases the corresponding period patients diagnosed of ovarian cancer without endometriosis,group C of 7 cases patients with endometriosis combined with ovarian cancer,and group D of 70 cases healthy people. According to the patients＇ age,patients in each group were divided into two parts before and after the menopause,the levels of serum were detected such as HE4,CA125 and CA199,etc.,and the ROMA index was calculated. Results CA125,HE4,CA199 of premenopausal and postmenopausal patients in four groups through pairwise comparison were statistically significant（ P〈0. 01）. The tumor markers detected in premenopausal simple endometriosis patients were higher than that in healthy people. ROMA risk assessment showed that： endometriosis had some relevance to ovarian cancer; the indicators of patients with endometriosis and ovarian cancer were higher than that in patients with simple endometriosis,but lower than the group of patients with ovarian cancer alone,and possibly had ovarian cancer. There was no significant difference between premenopausal patients with combined diseases and patients with simple ovarian cancer（ P〈0. 05）. All simple ovarian cancer groups were compared with the combined group： simple ovarian cancer groups were mainly at stage III,the combined group was mainly at stage I,the differences were statistically significant（ χ2= 4. 96,P〈0. 01）. The proportion of clear cell carcinoma in the combined group was higher than simple ovarian cancer group（ χ2= 8. 59,P〈0. 01）. Conclusions Endometriosis may cause ovarian tumors,and is mainly associated with clear cell carcinoma. Furthermore,patients with endometriosis have a higher proportion of early tumors,so early intervention treatment should be given to patients with endometriosis in clinical.