卵巢子宫内膜异位症恶变与卵巢癌患者临床病理特征对比分析

Comparative Study on the Clinicopathological Features of Malignant Transformations of Endo-metriosis and Ovarian Cancer

【目的】探讨卵巢子宫内膜异位症（EMS）恶变患者的临床病理学特征、远期预后与卵巢癌患者的差异。【方法】选取本院2009年1月至2012年1月收集的EMS恶变卵巢癌患者（观察组）80例、非EMS恶变卵巢癌患者（对照组）80例，对比两组惠者的临床病理学特征及远期预后。【结果】观察组患者年龄≤50岁患者的比例高于对照组（P〈O．05）；Ⅲ＋Ⅳ期、血清CA-125水平〉1000U／mL患者比例低于对照组（P〈O．05）；两组其他指标比较差异也均具有统计学意义（P〈0．05）；观察组惠者的5年生存率68．75％（55／80），显著高于对照组的50．00％（40／80），其差异均有统计学意义（x2=5．830，P=0．016）；以5年生存率为因变量，以年龄、阴道是否不规则出血、肿瘤直径、FIGO分期、病理学类型、CA125、是否EMS恶变作为自变量。Logistic回归分析显示：FIG（）高分期、浆液性腺癌、CAl25〉10001U／mI。是卵巢癌患者的不良预后的独立危险因素（P〈0．05），EMS恶变患音相对于非EMS恶变卵巢癌患者的预后较好（OR值为0．682，P〈0．05）。【结论]EMS恶性变患者的临床特征与非EMS恶变的卵巢癌患者的临床病理特征差异明显，EMS恶变患者相对于非EMS恶变卵巢癌惠者的预后较好。

[Objective]To investigate the clinicopathological features and long-term prognosis of endome- triosis malignant transformations （EMS） to reveal its differences from ovarian cancer. [Methods]Eighty pa- tients with EMS malignant ovarian cancer （observation group） and 80 patients with non-EMS malignant ovari an cancer （control group） who were in our hospital from January 2009 to January 2012 were selected. The clin- icopathological characteristics and prognosis of the two groups were compared. [Results]The proportion of pa- tients less than 50 years old in the observation group was higher than that in the control group （ P 〈0.05）. The proportion of patients with stage Ⅲ-Ⅳ and serum CA-125〉1000 U / mL. was lower than that of the control group （ P 〈C0.05）. The other indicators in the two groups were also statistically significant differences （ P 〈0.05）. The 5 year survival rate was 68.75% （55/80） in the observation group, which was significantly higher than that in the control group （50.00%, 40/80） ; the difference was statistically significant （X=5.830, P =0.016）. The 5 year survival rate was taken as the dependent variable, with age, irregular vaginal bleed- ing, tumor diameter, FIGO stage, pathological type, CA125, whether EMS malignant as independent varia- bles. Logistic regression analysis showed that FIC-O hyperplasia, serous adenocarcinoma and CA125 〉 1000 1U/mL were independent risk factors for poor prognosis in patients with ovarian cancer （ P 〈 0.05）. The prognosis of patients with EMS malignant lesions was relatively better than that of non EMS malignant ovarian cancer patients （OR=0.682, P 〈0.05）.[Concluslon]The clinical features of patients with malignant change of EMS are quite different from the clinical pathological characteristics of patients with non EMS malignant trans- formed ovarian cancer. Patients with EMS malignancy have a better prognosis than patients with non EMS ma- lignant ovarian cancer.