CAJ | 학술논문

目的分析卵巢上皮性癌(EOC)脐转移的临床特点,探讨其发生率、诊断、治疗及预后相关因素.方法回顾性分析1991年1月至2011年1月中山大学肿瘤防治中心收治的EOC患者2642例中经不同取材病理组织学确诊发生脐转移的21例患者的临床病理资料,21例年龄40～66岁.结果 EOC脐转移的发生率为0.79％.未控或复发转移至脐者较初始治疗时已有脐转移者预后差(22比6个月,P＜0.01),行姑息或不规则治疗者较采取积极规范手术联合规则化疗者的预后差(21比4个月,P＜0.01).脐转移的确诊时间及确诊后的治疗措施是影响预后的独立危险因素.结论提高对EOC患者发生脐转移诊断的警惕性,综合评估病情及治疗耐受,采取积极的肿瘤细胞减灭术配合规则化疗为主的综合治疗有助于此类患者病情的控制并延长其生存时间.
목적 분석란소상피성암(EOC)제전이적림상특점,탐토기발생솔、진단、치료급예후상관인소.방법 회고성분석1991년1월지2011년1월중산대학종류방치중심수치적EOC환자2642례중경불동취재병리조직학학진발생제전이적21례환자적림상병리자료,21례년령40～66세.결과 EOC제전이적발생솔위0.79％.미공혹복발전이지제자교초시치료시이유제전이자예후차(22비6개월,P＜0.01),행고식혹불규칙치료자교채취적겁규범수술연합규칙화료자적예후차(21비4개월,P＜0.01).제전이적학진시간급학진후적치료조시시영향예후적독립위험인소.결론 제고대EOC환자발생제전이진단적경척성,종합평고병정급치료내수,채취적겁적종류세포감멸술배합규칙화료위주적종합치료유조우차류환자병정적공제병연장기생존시간.
Objective To analyze the clinical features,treatments and prognosis of patients with Sister Mary Joseph's nodule of umbilicus (SMJN) from epithelial ovarian cancer (EOC) patients.Methods Among a total of 2642 pathologically diagnosed EOC cases,21 cases with SMJN were histopathologically diagnosed and had an age range of 40-66 years at Sun Yat-sen University Cancer Center between January 1991 and January 2011.Their clinical data were retrospectively analyzed.Results The incidence of SMJN in EOC was 0.79％.The 1,2 and 5-year survival rates were 61.8％,26.8％ and 9.5％ respectively.The diagnosis was confirmed via local excision biopsy,fine-needle aspiration biopsy or gross pathological diagnosis.Univariate analysis showed that patients with progressive disease or relapsing with umbilical metastasis after treatment had worse prognosis than those diagnosed at pre-treatment (22 vs 6 months,P ＜ 0.01).Patients with suboptional cytoreductive surgery and/or less than 6 circles of chemotherapy or palliative treatment had worse prognosis than those with optional cytoreductive surgery during 6-8 circles of chemotherapy (21 vs 4 months).Multivarivate analysis showed that the time to diagnose and treatment regimen were independent predictors of survival (relative risk =41.28,P ＜ 0.01).Conclusion SMJN is a rare manifestation of EOC.Improving the diagnostic vigilance,optimal debulking surgery plus regular chemotherapy and other new individualized postoperative treatments may arrest the progression of EOC and prolong patient survival.