子宫内膜异位症与卵巢癌相关性临床分析

Association of endometriosis and ovarian cancer

目的:探讨子宫内膜异位症(内异症)与卵巢癌的相关性。方法:收集199例卵巢癌患者,分内异症组(n=32),非内异症组(n=167),回顾性分析两组患者一般情况、临床表现、病理特征、实验室检查及预后。结果:内异症组平均年龄明显小于非内异症组(P<0.05),年龄<50岁、未生育患者构成比明显高于非内异症组;内异症组患者临床症状以月经改变和下腹痛、腹胀为主(P<0.05);内异症组肿瘤直径通常小于20cm,且主要在10-20cm之间,非内异症组肿瘤直径大部分为10-20cm;内异症组患者血CA125主要在200-1000k U/L之间,非内异症组大部分在200k U/L以下;内异症组患者以透明细胞癌、宫内膜样癌为主,非内异症组以浆液性囊腺癌为主(P<0.05);内异症组患者分期较早,I期、Ⅱ期占合并卵巢癌患者68.8%,非内异症组分期多处于Ⅱ期、Ⅲ期,占原发卵巢癌患者70.1%(P<0.05);内异症组患者病灶部位多位于左侧卵巢,非内异症组病灶部位在左侧、右侧、双侧分布较接近(P<0.05);内异症组5年生存率为59.4%,非内异症组5年生存率为34.7%,两组差异具有统计学意义(P<0.05)。结论:应充分了解内异症恶变的临床症状及病理特征,提高早期诊断率。

Objective ：To investigate the association of endometriosis and ovarian cancer. Methods：All 198 cases with ovarian cancer were divided into endometriosis group （n = 32 ）, non endometriosis group（ n = 167 ）, patients＇ general character, clinical manifestations, pathology, laboratory examination and prognosis were analysised. Results： The average age of endometriosis group was obviously less than that of non endometriosis group （ P 〈 0. 05 ） , age 〈 50 years old and unmarried patients in endometriosis group were more than that in non endometriosis group;clinical symptom were mostly abdominal pain, abdominal distension and menstrual （P 〈 0.05 ）. Tumor diameter were usually less than 20cm, that in non endometriosis group were 10 -20cm. CA125 were mainly in range of 200 -1000kU/L, That in non endometriosis group were mostly below 200kU/L. Tumour types were mostly clear cell carcinoma, endometrioid carcinoma, that in non endometriosis group were mainly serous cystadenocarcinoma;tumor staging were mostly stage Ⅰ, stage Ⅱ accounted for 68.8% ,that in non endometriosis group were mostly stage Ⅱ, Ⅲ accounted for 70.1% （P〈0.05） ;lesions located mostly in left ovary, that in non endometriosis group were mostly close in left, right, bilateral distribution （P 〈0.05）;5 year survival rate was 59.4%, that in non endometriosis group was 34.7% （P 〈 0.05 ）. Conclusion： Clinicians should give priority to prevention, fully understand clinical symptoms and pathological characteristics of malignant transformation of endometriosis,to improve early diagnosis rate.