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 features and prognosis of endometriosis-associated ovarian cancer

目的 分析子宫内膜异位症相关性卵巢癌(EAOC)临床病理特征及预后情况。方法 纳入2012年1月至2018年7月经手术病理明确诊断的卵巢透明细胞癌及卵巢子宫内膜样腺癌98例作为研究对象,根据是否有子宫内膜异位症(EM)恶变分为2组,51例卵巢癌子宫内膜异位症恶变者设为EM-EAOC组,47例无子宫内膜异位症恶变的卵巢癌患者设为NEM-EAOC组,对2组基础资料、病理特征、预后等情况进行分析。结果 EM-EAOC组年龄≤50岁者,初潮年龄≤13岁、已绝经、促卵泡生成素(FSH)≥10 U/L、肿瘤长径、病理分期Ⅰ~Ⅱ期比例均高于NEM-EAOC组,CA125>200 U/ml、淋巴结转移比率低于NEM-EAOC组(P<0.05);EM-EAOC组5年生存率大于NEM-EAOC组,组间比较差异有统计学意义(P<0.05);肿瘤分期、是否EMT恶变是影响患者预后的重要因素(P<0.05)。结论 EAOC与EM-EAOC存在不同的临床病理特征,病理分期、子宫内膜异位症是否恶变是影响卵巢癌预后的重要因素;由子宫内膜异位症恶变而来的卵巢癌有相对较好的预后,但仍应积极防治,降低EAOC的发生率。

Objective To investigate the clinicopathological features and prognosis of endometriosis-associated ovarian cancer(EAOC).Methods A total of 98 cases of ovarian clear cell carcinoma or ovarian endometrioid adenocarcinoma confirmed by post-surgical pathology between January 2012 and July 2018 were included as study subjects,and divided into two groups according to whether there was malignant transformation of endometriosis.Fifty-one ovarian cancer patients with malignant transformation of the endometriosis were assigned to the endometriosis(EM)-EAOC group,and 47 others without malignant transformation endometriosis to the NEM-EAOC group.The baseline data,pathological characteristics,prognosis and high-risk factors were compared between the two groups.Results Compared with those in the NEM-EAOC group,the patients in the EM-EAOC group were more likely to have an age≤50 years,menarche no later than 13 years old,be men-opausal,show higher proportions of FSH≥10 U/L,small tumor size,stagesⅠ-Ⅱcancer by post-surgical pathology,while less likely to have CA125>200 U/ml and lymph node metastasis(P<0.05).The 5-year survival rate was higher in the EM-EAOC group than that in the NEM-EAOC group,with significant difference between groups(P<0.05).Tumor staging and malignant transformation of endometriosis were important factors affecting the patient prognosis(P<0.05).Conclusion EM-EAOC and NEM-EAOC differ in clinicopathological features.Pathological staging and malignant transformation of endometriosis are important factors affecting the prognosis of ovarian cancer.Ovarian cancer resulting from malignant transformation of endometriosis may have a relatively better prognosis.However,proactive measures for prevention and treatment should be a priority to reduce the incidence of EAOC.