卵巢透明细胞癌临床病理特点及预后影响因素分析

Analysis on clinicopathological features and influencing factors of prognosis of ovarian clear cell carcinoma

目的探讨卵巢透明细胞癌的临床病理特点并分析预后影响因素。方法回顾性分析2007年1月-2014年12月复旦大学附属妇产科医院诊治并经病理证实的139例卵巢透明细胞癌患者的临床病理资料。采用SPSS 20.0统计学软件对数据进行统计分析,应用Kaplan-Meier法绘制生存曲线,log-rank检验单因素分析,组间比较使用χ2检验或Fish's精确检验。结果卵巢透明细胞癌的平均发病年龄是51.80岁,63.31%的患者FIGO分期为Ⅰ期,总体预后相对较好,5年总生存率为84.63%,5年无病生存率为72.95%。ⅠA期与ⅠC1期患者预后比较,差异无统计学意义(P>0.05),ⅠC1期与ⅠC2期和ⅠC3期患者预后比较,差异有统计学意义(P<0.05)。影响患者总的生存时间的因素有FIGO分期、淋巴结转移、满意的瘤体减灭术。FIGO分期与是否化疗耐药是预后的独立影响因素。结论卵巢透明细胞癌相对其他上皮性卵巢癌发病年龄早,诊断时多为Ⅰ期,早期患者预后相对较好,术中破裂并不影响Ⅰ期患者的预后,FIGO分期和化疗耐药是预后的独立影响因素。

Objective To explore the clinicopathological features of ovarian clear cell carcinoma（ OCCC）,analyze the influencing factors of prognosis. Methods The clinicopathological data of 139 patients with OCCC who were diagnosed,treated,and confirmed by pathological examination in the hospital from January 2007 to December 2014 was analyzed retrospectively,then the data was analyzed by SPSS20. 0 statistical software,Kaplan-Meier method was used to draw survival curves,Log-rank test was performed,χ^2test or Fish＇s exact test was used to compare the data between groups. Results The average age of patients was 51. 80 years old. Among the patients,63. 31% of them were at FIGO stage Ⅰ,and the prognosis was good. The five-year overall survival（ OS） was 84. 63%,the five-year disease-free survival was 72. 95%. There was no statistically significant difference in the prognosis between the patients of stage Ⅰ A and the patients of stage ⅠC1（ P〉0. 05）; there was no statistically significant difference in the prognosis between the patients of stage ⅠC1 and the patients of stage ⅠC2 and ⅠC3（ P〈0. 05）. The influencing factors of overall survival time included FIGO stage,lymph node metastasis,satisfactory cytoreductive surgery. FIGO stage and chemotherapy resistance were independent influencing factors of prognosis. Conclusion Compared with other ovarian epithelial carcinoma patients,the age of OCCC patients is younger,FIGO stage is early,the prognosis of patients with early FIGO stage is good,intraoperative rupture doesn＇t affect the prognosis of patients of FIGO stage Ⅰ,FIGO stage and chemotherapy resistance are independent influencing factors of prognosis.