Ⅰ期卵巢透明细胞癌患者临床病理特点及预后分析——北京协和医院12年临床资料回顾性分析

Clinicopathological features of stage I ovarian clear cell carcinoma: retrospective analysis of 12 years’ clinical data in Peking Union Medical College Hospital

目的:回顾分析Ⅰ期卵巢透明细胞癌患者的临床病理特点及预后。方法:回顾分析2000年1月至2012年3月北京协和医院妇产科收治的65例Ⅰ期卵巢透明细胞癌患者的临床资料,对其诊疗情况进行总结并分析预后。结果:65例(53.7%)患者的平均发病年龄49.6岁(30~67岁),1例Ⅰa期患者行子宫双附件切除,64例行卵巢癌全面分期术。53例(81.5%)患者手术病理分期为Ⅰc期,12例为Ⅰa期。27例(41.5%)患者合并卵巢子宫内膜异位症。62例患者术后辅助化疗,其中2例出现化疗耐药。平均随访时间70.7个月,9例患者复发,1例患者死亡。患者5年生存率100%,2年和5年无病生存率分别为95.3%和87.7%。结论:卵巢透明细胞癌患者中约50%在诊断时处于Ⅰ期,Ⅰ期患者术前多无症状,最常见症状为盆腔包块。生长相对缓慢、手术切净率高、混合型病理比例低、化疗耐药率低等特点使得其拥有较好的总体预后。

Objective:To explore the clinicopathological features and treatment strategy of stage Ⅰ ovarian clear cell carcinoma.Methods:Medical records of 65 patients with stage Ⅰ ovarian clear cell carcinoma treated in our hospital from Jan.2000 to Mar.2012 were analyzed retrospectively.Results:65(53.7%) stage Ⅰ patients were included.The average age at diagnosis was 49.6 years(range 30~67 years).Among the patients,81.5% were at stage Ⅰc,and the rest were stage Ⅰa.1 patient with stage Ⅰa who underwent TAH+BSO,64 patients underwent complete surgical staging.There were 27(41.5%) patients with endometriosis.62 patients received postoperative adjuvant chemotherapy,2 of whom acquired resistance to chemotherapy.At a mean follow-up of 70.7 months,9 patients developed postoperative recurrence,and 1 patient died.The 5-year survival rate was 100%,and the 2-year and 5-year disease-free survival rates were 95.3% and 87.7%,respectively.Conclusion:Patients with stage Ⅰ ovarian clear cell carcinoma can achieve a high surgical resection rate,and have low resistance to chemotherapy and comparatively good prognosis.