腹壁子宫内膜异位症相关性透明细胞癌的诊治进展

Research Progress on the Diagnosis and Treatment of Abdominal Wall Endometriosis-Associated Clear Cell Carcinoma

腹壁子宫内膜异位症相关性透明细胞癌(abdominal wall endometriosis-associated clear cell carcinoma,AWECC)发病率低,侵袭性强,预后差,相关文献报道较少。AWECC多由腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)恶变形成。随着剖宫产等进入宫腔的盆腔手术数量增加,AWE的发病率呈上升趋势,但其恶变机制尚不明确。AWECC缺乏特异性的临床特征,临床上易被误诊为AWE,确诊依赖于病理检查。AWECC的治疗多来源于临床医生的个人经验,差异性大,缺乏相应的指南推荐。临床上多采用以扩大腹壁肿瘤切除术为主的手术治疗,化疗和放疗能否使AWECC患者获益尚需进一步探讨。目前关于AWECC的研究多为个案报道,综合国内外文献,探讨AWECC的发病、诊断、治疗及预后,以期引起临床医生对疾病诊断的重视,为临床诊治和随访提供证据。

Abdominal wall endometriosis-associated clear cell carcinoma(AWECC)is characterized by low incidence,high invasiveness and poor prognosis.To date,there have been relatively few reports on AWECC.AWECC primarily originates from the malignant transformation of abdominal wall endometriosis(AWE).In recent years,there has been a rising incidence of AWECC,possibly attributed to the increased number of pelvic and abdominal surgeries,including cesarean section.Nevertheless,the mechanisms underlying its malignant transformation remain unclear.AWECC lacks specific clinical features,making it challenging to distinguish from benign AWE.The definitive diagnosis depends on histological examination.The treatment of AWECC primarily lies on the clinicians′personal experience,which varies greatly,and lacks corresponding guidelines.In clinical practice,surgical treatment with extended resection of the abdominal wall tumor,is typically employed.The efficacy of chemotherapy and radiotherapy in AWECC patients requires further investigation.Until now,most of the studies on AWECC have been case reports.Therefore,we reviewed the pathogenesis,diagnosis,treatment and prognosis of AWECC based on domestic and foreign literature,so as to arouse the attention of clinicians to the diagnosis of the disease and provide evidence for clinical diagnosis,treatment and follow-up.