卵巢子宫内膜异位症恶变的临床病理特征分析

Clinicopathological characteristics of malignant transformation of ovarian endometriosis

目的:分析卵巢子宫内膜异位症(EMs)恶变的临床病理特征。方法:回顾分析2011年12月至2015年12月于郑州大学人民医院妇科行手术治疗且术后病理确诊的卵巢癌患者281例,其中符合内异症恶变诊断标准者24例(内异症恶变组),非内异症恶变者257例(非内异症恶变组)。分析两组患者的临床组织病理学类型及FIGO分期。结果:与非内异症恶变组相比,内异症恶变组患者的平均年龄早、绝经前诊断比例较大,差异均有统计学意义(P<0.05)。内异症恶变组术前CA125值(110.27±112.62)U/ml,腹水量较少、病理类型多为透明细胞癌(45.83%)、FIGO分期早期(87.50%);非内异症恶变组术前CA125值(1242.75±2104.28)U/ml、腹水量较多,病理类型多为浆液性腺癌(72.37%),FIGO分期晚期(74.71%);两组比较,差异均有统计学意义(P均<0.05)。两组患者在癌灶单双侧及淋巴结转移情况比较,差异均无统计学意义(P均>0.05)。结论:卵巢内异症恶变患者发病年龄小、腹水量少、术前CA125较低、FIGO期别早,组织病理以透明细胞癌及子宫内膜样腺癌为主。

Objective： To analysis the clinicopathological features of malignant transformation of ovarian endometriosis. Method： A retrospective analysis was conducted on 281 patients treated by surgical treatment and confirmed by postoperative pathology and met the criteria of ovarian cancer in Department of Obstetrics and Gynecology,People’s Hospital of Zhengzhou University between 2011 and 2015.24 ovarian cancer arising in endometriosis of all were malignant transformation of endometriosis group. The rest was non-malignant transformation of endometriosis.The clinical characteristics and pathology between the two groups were compared.Result： Compared with non-malignant transformation of endometriosis group,the patients in malignant transformation of endometriosis group were more likely to have younger age,lower CA125 level,less ascites and earlier FIGO stage.The main subtypes was clear cell carcinoma in malignant transformation of endometriosis group and serous adenocarcinoma in non-malignant transformation of endometriosis group. There were no significant difference between the two groups in the location of the tumor and lymph node metastasis（ P〉0.05）.Conclusion： The malignant of ovarian endometriosis change in patients with young age,less ascites,low CA125 in preoperative,early stage,and clear cell carcinoma and endometrioid adenocarcinoma based features.