45例原发女性生殖器透明细胞癌临床分析

Clinical Analysis of Forty-five Patients of Primary Clear Cell Carcinoma of Female Genital Tract

目的:了解原发女性生殖器透明细胞癌的临床特征、治疗及预后。方法:对我院1962年1月～2000年12月收治的45例原发女性生殖器透明细胞癌患者进行回顾性分析。结果:45例原发女性生殖器透明细胞癌中阴道透明细胞癌3例,宫颈透明细胞癌11例,子宫体透明细胞癌6例,卵巢透明细胞癌25例。平均年龄50岁,其中阴道透明细胞癌患者最小,为33.7岁;宫体透明细胞癌患者最大,为58.3岁。原发女性生殖器透明细胞癌的临床症状与普通腺癌相似,但局部肿瘤较大;以早期肿瘤多见,其中Ⅰ+Ⅱ期患者占68.9%,其5年生存率分别为77.3%和77.8%,明显高于Ⅳ期和Ⅳ期患者的5年生存率27.3%和0%(P<0.01);阴道和卵巢透明细胞癌的5年生存率分别为66.7%和68.0%;明显高于宫颈、宫体透明细胞癌的5年生存率54.6%和16.7%,但统计学检验,均无显著性差异(P>0.05)。结论:原发女性生殖器透明细胞癌早期占多数,分期是影响预后的主要因素,肿瘤易出现腹膜后淋巴结转移和肺转移。

Objective:To comprehend the clinical characterist ic s,treatment and prognosis of pri)mary clear cell carcinoma of female genital t ract(PCCCOFGT).Methods:Forty)five patients with PC)CCOFGT were analyzed re trospectively from January1962to December2000.Results:Forty)five pa) tients with PCCCOFGT were classified as3patients of vaginal clear cell carcinom a,11patients of cer)vical of cervical clear cell carcinoma,6patients of en dometrial clear cell carcinoma,and25patients of ovarian clear cell carcinoma .The total mean age of45patients was50years,the youngest were the pa)tien ts of vaginal clear cell carcinoma whose mean age were33.7years,and the old est were the patients of endometrial clear cell carcinoma whose mean age were5 8.3years.The clinical symptoms of PCC)COFGT were similar to those of common adenocarcinoma,but the local masses originating from the vaginal,cervix,endo metrium and ovary were usually bigger.Most of patients were diagnosed as early stage,and the patients who were diagnosed as stag I and stage were accounted of68.9%.The5)year survival rate of patients with stag e I and stage II ,which was77.3%and77.8%respectively,was obviously higher than th at of patients with stage III and stage II ,which was27.3%and0%respective)ly(P<0.001).Although the5 )year survival rate of patients with vaginal clear cell carcinoma and with ovar ian clear cell carcinoma was66.7%and68.0%respectively,higher than tha t of patients with cer)vical clear cell carcinoma and with endometrial clear ce ll carcinoma,which was54.6%and16.7%re)spectively,they were not sign ificantly difference by statistical test(P>0.05).After treatment,PCC) COFGT easily recur and metastasize to the retroperitoneal lympho node and lu ng. Conclusions: The most of patients of PCCCOFGT were diagnosed as early stage.The stage wa s the most important factor effected on prognosis,and PCCCOFGT frequently metas tasized to the retroperitoneal lympho node and lung.