子宫内膜异位症相关性卵巢癌临床病理特征及预后分析

Clinicopathological Characteristics and Prognosis of Endometriosis-Associated Ovarian Cancer:A Retrospectively Analysis

目的:探讨子宫内膜异位症相关性卵巢癌(EAOC)患者的临床资料及预后特点。方法:选择2011年1月至2014年1月于武汉大学人民医院妇科手术确诊为卵巢透明细胞癌(OCCC)及卵巢子宫内膜样腺癌(OEC)患者共181例,依据卵巢癌与卵巢子宫内膜异位症(卵巢EMT)间的关系分为卵巢EMT恶变组(EAOC组,35例)、合并卵巢EMT组(31例)、未合并卵巢EMT组(115例)。回顾性分析3组在临床、病理特征以及化疗、预后方面的异同点。结果:(1)3组患者在发病年龄、产次、合并不孕症、CA125值升高比例、病理分期、淋巴结转移方面差异有统计学意义(P<0.05)。(2)3组患者在化疗耐药、肿瘤复发方面差异无统计学意义(P>0.05)。5年累积生存率分别为74.3%(EAOC组)、48.4%(合并卵巢EMT组)、47.8%(未合并卵巢EMT组),差异有统计学意义(P<0.05)。生存曲线比较:EAOC组优于合并卵巢EMT组、未合并卵巢EMT组(P<0.05),合并卵巢EMT组略优于未合并卵巢EMT组,差异无统计学意义(P>0.05)。(3)预后影响因素分析:在EAOC组与合并卵巢EMT组中,EMT恶变是唯一影响因素(P<0.05);EAOC组与未合并卵巢EMT组中,病理分期、EMT恶变是影响预后的独立重要因素(P<0.05)。结论:EAOC患者具有一些特有的临床病理特征,病理分期、EMT恶变是影响卵巢癌预后的重要因素,与EMT相关的卵巢癌预后相对较好。

Objective:To investigate the clinicopathological characteristics and prognosis of patients with endometriosis-associated ovarian cancer(EAOC).Methods:A total of 181 medical records of patients with ovarian clear cell carcinoma(OCCC)and ovarian endometrioid carcinoma(OEC)at Renmin Hospital of Wuhan University from January 2011 to January 2014 were collected.According to the association between ovarian cancer and ovarian endometriosis(ovarian EMT),181 patients were assigned into ovarian EMT malignant group(EAOC group,35 cases),combined ovarian EMT group(31 cases),and uncombined ovarian EMT group(115 cases).The similarities and differences in clinicopathological characteristics,chemotherapy and prognosis among these three groups were analyzed.Results:(1)There were significant differences among the three groups in terms of age at onset,parity,combined infertility,propotion of CA125level increase,pathological stage,and lymph node metastasis(P<0.05).(2)There was no significant difference in chemotherapy resistance and tumor recurrence among the three groups(P>0.05).The 5-year cumulative survival rates were 74.3%in EAOC group,48.4%in combined ovarian EMT group and 47.8%in uncombined ovarian EMT group,respecticely.The differences were statistically significant(P<0.05).As to the Comparison of survival curves among these three groups,the EAOC group was superior to the combined ovarian EMT group and the uncombined ovarian EMT group(P<0.05),and the combined ovarian EMT group was slightly better than the uncombined ovarian EMT group,and the difference was not statistically significant(P>0.05).(3)Analysis of prognostic factors:Compared with EAOC group and combined ovarian EMT group,EMT malignant change was the only risk factor(P<0.05).EAOC group compared with uncombined ovarian EMT group,pathological stage and EMT malignant change were independent prognostic factors(P<0.05).Conclusions:Compared with the other two groups,the EAOC group has some unique clinicopathological characteristics.Pathological stage and EMT malignant changes are important factors affecting the prognosis of ovarian cancer,and the prognosis of ovarian cancer related to EMT is relatively good.