中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2009年
11期
832-836
,共5页
卢媛%刘茂华%郑峪%郭孙伟%刘惜时
盧媛%劉茂華%鄭峪%郭孫偉%劉惜時
로원%류무화%정욕%곽손위%류석시
卵巢肿瘤%子宫内膜异位症%腺癌%透明细胞%癌%子宫内膜样%预后
卵巢腫瘤%子宮內膜異位癥%腺癌%透明細胞%癌%子宮內膜樣%預後
란소종류%자궁내막이위증%선암%투명세포%암%자궁내막양%예후
Ovarian neoplasms%Endometriosis%Adenocarcinoma%clear cell%Carcinoma%endometrioid%Prognosis
目的 探讨合并卵巢子宫内膜异位症(内异症)的卵巢上皮性癌(卵巢癌)的临床病理特点.方法 选取1996年1月至2006年12月在复旦大学附属妇产科医院就诊并经手术确诊的卵巢癌共727例,对其中合并卵巢内异症的67例患者(其中由卵巢内异症恶变的卵巢癌患者34例,为A组;其他仅合并卵巢内异症的卵巢癌患者33例,为B组)的临床病理资料进行回顾性分析,并与660例未合并卵巢内异症的卵巢癌患者(C组)进行对照分析.同期本院经手术病理确诊的卵巢内异症患者共3890例.结果 卵巢内异症恶变为卵巢癌的发生率为0.87%(34/3890).卵巢癌合并卵巢内异症的发生率为9.2%(67/727).A、B、C组患者的平均年龄分别为(47.2±1.3)、(47.8±1.2)、(51.2±0.4)岁,3组问比较,差异有统计学意义(P=0.013).A、B组病理类型多为透明细胞癌(分别为67.6%、69.7%),其所占比例均明显高于C组的18.8%(P=0.000);而C组以浆液性腺癌(50.3%)为主,其所占比例明显高于A组的8.8%和B组的12.1%(P=0.000).A、B组手术病理分期多为Ⅰ期(分别为73.5%、63.6%),其所占比例均明显高于C组的31.4%(P=0.000);而C组多为Ⅲ期(47.7%),其所占比例明显高于A组的23.5%和B组的15.2%(P=0.001).A、B、C组高分化(分别为11.8%、6.1%、10.5%)、中～低分化(分别为88.2%、93.9%、89.5%)所占比例分别比较,差异均无统计学意义(P=0.602).A、B、C组雌激素受体(ER)阳性率分别为22.2%(6/27)、31.6%(6/19)、43.9%(136/310),3组间比较,差异有统计学意义(P=0.018);A、B、C组孕激素受体(PR)阳性率分别为22.2%(6/27)、15.8%(3/19)、35.5%(110/310),3组间比较,差异无统计学意义(P=0.082).患者总的5年累积生存率为55.6%,A、B、C组患者的5年累积生存率分别为78.9%、92.8%、51.9%,3组间比较,差异有统计学意义(P=0.000).结论 合并卵巢内异症的卵巢癌患者,具有年轻(尤其是内异症恶变患者)、多为卵巢透明细胞癌、期别早、ER表达水平低、预后好的特点.
目的 探討閤併卵巢子宮內膜異位癥(內異癥)的卵巢上皮性癌(卵巢癌)的臨床病理特點.方法 選取1996年1月至2006年12月在複旦大學附屬婦產科醫院就診併經手術確診的卵巢癌共727例,對其中閤併卵巢內異癥的67例患者(其中由卵巢內異癥噁變的卵巢癌患者34例,為A組;其他僅閤併卵巢內異癥的卵巢癌患者33例,為B組)的臨床病理資料進行迴顧性分析,併與660例未閤併卵巢內異癥的卵巢癌患者(C組)進行對照分析.同期本院經手術病理確診的卵巢內異癥患者共3890例.結果 卵巢內異癥噁變為卵巢癌的髮生率為0.87%(34/3890).卵巢癌閤併卵巢內異癥的髮生率為9.2%(67/727).A、B、C組患者的平均年齡分彆為(47.2±1.3)、(47.8±1.2)、(51.2±0.4)歲,3組問比較,差異有統計學意義(P=0.013).A、B組病理類型多為透明細胞癌(分彆為67.6%、69.7%),其所佔比例均明顯高于C組的18.8%(P=0.000);而C組以漿液性腺癌(50.3%)為主,其所佔比例明顯高于A組的8.8%和B組的12.1%(P=0.000).A、B組手術病理分期多為Ⅰ期(分彆為73.5%、63.6%),其所佔比例均明顯高于C組的31.4%(P=0.000);而C組多為Ⅲ期(47.7%),其所佔比例明顯高于A組的23.5%和B組的15.2%(P=0.001).A、B、C組高分化(分彆為11.8%、6.1%、10.5%)、中～低分化(分彆為88.2%、93.9%、89.5%)所佔比例分彆比較,差異均無統計學意義(P=0.602).A、B、C組雌激素受體(ER)暘性率分彆為22.2%(6/27)、31.6%(6/19)、43.9%(136/310),3組間比較,差異有統計學意義(P=0.018);A、B、C組孕激素受體(PR)暘性率分彆為22.2%(6/27)、15.8%(3/19)、35.5%(110/310),3組間比較,差異無統計學意義(P=0.082).患者總的5年纍積生存率為55.6%,A、B、C組患者的5年纍積生存率分彆為78.9%、92.8%、51.9%,3組間比較,差異有統計學意義(P=0.000).結論 閤併卵巢內異癥的卵巢癌患者,具有年輕(尤其是內異癥噁變患者)、多為卵巢透明細胞癌、期彆早、ER錶達水平低、預後好的特點.
목적 탐토합병란소자궁내막이위증(내이증)적란소상피성암(란소암)적림상병리특점.방법 선취1996년1월지2006년12월재복단대학부속부산과의원취진병경수술학진적란소암공727례,대기중합병란소내이증적67례환자(기중유란소내이증악변적란소암환자34례,위A조;기타부합병란소내이증적란소암환자33례,위B조)적림상병리자료진행회고성분석,병여660례미합병란소내이증적란소암환자(C조)진행대조분석.동기본원경수술병리학진적란소내이증환자공3890례.결과 란소내이증악변위란소암적발생솔위0.87%(34/3890).란소암합병란소내이증적발생솔위9.2%(67/727).A、B、C조환자적평균년령분별위(47.2±1.3)、(47.8±1.2)、(51.2±0.4)세,3조문비교,차이유통계학의의(P=0.013).A、B조병리류형다위투명세포암(분별위67.6%、69.7%),기소점비례균명현고우C조적18.8%(P=0.000);이C조이장액성선암(50.3%)위주,기소점비례명현고우A조적8.8%화B조적12.1%(P=0.000).A、B조수술병리분기다위Ⅰ기(분별위73.5%、63.6%),기소점비례균명현고우C조적31.4%(P=0.000);이C조다위Ⅲ기(47.7%),기소점비례명현고우A조적23.5%화B조적15.2%(P=0.001).A、B、C조고분화(분별위11.8%、6.1%、10.5%)、중～저분화(분별위88.2%、93.9%、89.5%)소점비례분별비교,차이균무통계학의의(P=0.602).A、B、C조자격소수체(ER)양성솔분별위22.2%(6/27)、31.6%(6/19)、43.9%(136/310),3조간비교,차이유통계학의의(P=0.018);A、B、C조잉격소수체(PR)양성솔분별위22.2%(6/27)、15.8%(3/19)、35.5%(110/310),3조간비교,차이무통계학의의(P=0.082).환자총적5년루적생존솔위55.6%,A、B、C조환자적5년루적생존솔분별위78.9%、92.8%、51.9%,3조간비교,차이유통계학의의(P=0.000).결론 합병란소내이증적란소암환자,구유년경(우기시내이증악변환자)、다위란소투명세포암、기별조、ER표체수평저、예후호적특점.
Objective To investigate clinicopathological features of endometriosis-associated epithelial ovarian carcinoma.Methods Retrospective follow-up study,clinicopathological data from patients with ovarian epithelial carcinoma were retrieved,analyzed and compared.Among the 727 cases,34 were found to originate from endometriosis (group A),33 were found to have co-existing ovarian endometriosis (group B),and the remaining 660 had no ovarian endometriosis at all (group C).Result Seven hundred and twenty-seven epithelial ovarian carcinoma patients were identified and their ehnicopathological data retrieved.Sixty-seven (9.2%) of these cases were found to have coexisting endometriosis.The frequency of malignant tumors arising from ovarian endometriosis in this case series was estimated to be 0.87% (34/3890).The mean (standard deviation) age in groups A,B,and C were(47.2±1.3),(47.8±1.2),(51.2±0.4) years,respectively,with patients in group C being significantly older (P = 0.013).Patients with coexisting ovarian endometriosis were mostly diagnosed at stage Ⅰ (P = 0.000)and having subtype of clear-cell (P =0.000),while other patients were mostly diagnosed at stage Ⅲ (P =0.001),and having subtype of serous carcinoma (P =0.000).The estrogen receptor (ER) positivity was significantly lower in groups A and B than that in group C (22.2%,31.6% vs 43.9%;P =0.018),but the difference in positivity of progestogen receptor among the three groups did not reach statistical significance (22.2%,15.8% vs 35.5%;P =0.082).While the five-year overall survival rate for all patients was 55.6%,significant difference in overall survival among the three groups was found 78.9%,92.8%,51.9%,respectively,for groups A,B and C (P =0.000).Conclusion Patients of endometriosis-associated epithelial ovarian carcinoma,especially patients with tumors arising from endometriosis,were found to be younger,having a significant lower stage and a better survival,and were mostly diagnosed with the subtype of clear-cell.
