子宫内膜异位症相关性卵巢癌的临床特征及预后分析

Clinical characteristics and prognosis of endometriosis-associated ovarian cancer

目的探究子宫内膜异位症(EMs)相关性卵巢癌(EAOC)的临床及预后特点。方法收集2011年1月1日至2019年12年30日于该院治疗的114例上皮性卵巢癌患者,包括卵巢透明细胞癌(CCOC)和卵巢子宫内膜样癌(ENOC)。根据是否合并EMs分为EAOC组47例和非EAOC(NEAOC)组67例。比较2组患者临床特征,分析生存情况。结果EAOC组确诊年龄小于NEAOC组[(48.57±6.76)岁vs.(52.27±9.58),P=0.017];EAOC组患者腹部不适发生率低于NEAOC组(31.91%vs.58.21%,P=0.006);EAOC组患者术后残留病灶≥2 cm比例高于NEAOC组,而残留病灶<2 cm低于NEAOC组(6.4%vs.0,93.6%vs.100%,P=0.031),差异均有统计学意义。EAOC组3年和5年存活率高于NEAOC组(70.2%vs.52.2%,53.2%vs.32.8%,P=0.100、0.053),但差异无统计学意义。Kaplan-Meier单因素生存分析结果提示月经异常(P=0.032、0.004)、残留病灶(均P<0.001)、化疗耐药(P=0.018、0.045)是影响EAOC患者总生存期(OS)和无病生存期(DFS)的因素,而FIGO分期(P=0.221、0.343)和主刀经验(P=0.778、0.904)均不是。经COX回归分析,以上因素均不是EAOC患者OS和DFS的独立影响因素(P>0.05)。结论发病较早、腹部不适发生率较低、残留病灶≥2 cm发生率较高是EAOC较独特的临床特征,月经异常、残留病灶、化疗耐药可能是EAOC患者预后的影响因素。

Objective To investigate the clinical features and prognostic characteristics of endometriosis(EMs)associated ovarian cancer(EAOC).Methods one hundred and fourteen patients with epithelial ovarian cancer,including ovarian clear cell carcinoma(CCOC)and ovarian endometrioid carcinoma(ENOC),who were treated in the hospital from January 1,2011 to December 30,2019 were selected and divided into the EAOC group(47 cases)and the non-EAOC group(NEAOC group,67 cases)according to whether EMs were combined.The clinical characteristics of the two groups of patients were compared,and their survival conditions were analyzed.Results The age of diagnosis in the EAOC group was younger than that in the NEAOC group[(48.57±6.76)years old vs.(52.27±9.58)years old,P=0.017];the incidence of abdominal discomfort in the EAOC group was lower than that in the NEAOC group(31.91%vs.58.21%,P=0.006);The proportion of residual lesions≥2 cm after operation in the EAOC group was higher than that in the NEAOC group,but<2 cm was lower than that in the NEAOC group(6.4%vs.0,93.6%vs.100%,P<0.05),and the differences were statistically significant.The 3-year and 5-year survival rate of the EAOC group was higher than that of the NEAOC group(70.2%vs.52.2%,53.2%vs.32.8%,P=0.100,0.053),but the differences were not statistically significant.Kaplan-Meier univariate survival analysis showed that abnormal menstruation(P=0.032,0.004),residual lesions(all P<0.001),and chemoresistance(P=0.018,0.045)were the factors affecting the total survival(OS)and disease-free survival(DFS)of EAOC patients,but the FIGO staging(P=0.212,0.343)and experience of the primary surgeon(P=0.778,0.904)were not.COX regression analysis coverted that,none of the above factors was an independent influence factor of OS and DFS in EAOC patients(P>0.05).Conclusion Earlier onset,low incidence of abdominal discomfort,and high proportion of residual lesions≥2 cm are the unique clinical features of EAOC.Menstrual abnormalities,residual lesions,and chemotherapy resistance may be the prognostic factors of EAOC patients.