CAJ | 학술논문

目的：探讨卵巢透明细胞癌（ovarian clear cell adenocarcinoma，OCCA）的临床病理特征和预后，以提高对该病的诊断、治疗与预后。方法收集136例OCCA患者的临床资料，分析患者的临床病理特征与预后的关系。采用Cox比例风险回归模型分析影响患者预后的因素。结果136例OCCA患者的总体5年生存率为40.8%，其中Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为70.7%、66.4%、15.9%、0。国际妇产科联合会（International Federation of Gynecology and Obstetrics，FIGO）术后病理分期为Ⅰ、Ⅱ、Ⅲ、Ⅳ期者分别为47.1%（64/136）、11.8%（16/136）、33.8%（46/136）、7.4%（10/136）。并发子宫内膜异位症38例（38/136，27.9%）。复发率41.9%（40/136）。单因素分析结果显示FIGO分期、是否并发子宫内膜异位症、淋巴结转移、残存肿瘤大小、足够的化疗疗程、无进展生存时间（progression free survival，PFS）是影响患者预后的因素（P＜0.05），而患者的发病年龄、腹腔积液/腹腔冲洗液细胞学结果、盆腔肿物大小和不同的化疗方案与预后无关（P＞0.05）。多因素分析结果显示PFS是OCCA患者预后的独立影响因素（P＜0.05）。结论满意的肿瘤细胞减灭术加上术后规范的辅助化疗可能改善OCCA患者的预后。
목적：탐토란소투명세포암（ovarian clear cell adenocarcinoma，OCCA）적림상병리특정화예후，이제고대해병적진단、치료여예후。방법수집136례OCCA환자적림상자료，분석환자적림상병리특정여예후적관계。채용Cox비례풍험회귀모형분석영향환자예후적인소。결과136례OCCA환자적총체5년생존솔위40.8%，기중Ⅰ、Ⅱ、Ⅲ、Ⅳ기분별위70.7%、66.4%、15.9%、0。국제부산과연합회（International Federation of Gynecology and Obstetrics，FIGO）술후병리분기위Ⅰ、Ⅱ、Ⅲ、Ⅳ기자분별위47.1%（64/136）、11.8%（16/136）、33.8%（46/136）、7.4%（10/136）。병발자궁내막이위증38례（38/136，27.9%）。복발솔41.9%（40/136）。단인소분석결과현시FIGO분기、시부병발자궁내막이위증、림파결전이、잔존종류대소、족구적화료료정、무진전생존시간（progression free survival，PFS）시영향환자예후적인소（P＜0.05），이환자적발병년령、복강적액/복강충세액세포학결과、분강종물대소화불동적화료방안여예후무관（P＞0.05）。다인소분석결과현시PFS시OCCA환자예후적독립영향인소（P＜0.05）。결론만의적종류세포감멸술가상술후규범적보조화료가능개선OCCA환자적예후。
Objective To investigate the clinicopathological features and prognosis of ovarian clear cell adenocar-cinoma (OCCA) and to improve the diagnosis, treatment and prognosis of this disease. Method The clinicopatholog-ical data of 136 patients with OCCA were analyzed retrospectively. Cox proportional hazards regression model were used to analyze those factors affecting prognosis. Result The overall 5-year survival rate was 40.8%, and for all pa-tients, the 5-year survival was 70.7% for those in stage I, 66.4% for stage II, 15.9% for stage III, and 0 for stage IV, respectively. As for FIGO staging, 47.1% (64/136) patients were in stage I, 11.8% (16/136) in stage II, 3.8% (46/136) stage III, and 7.4% (10/136) in stage IV. There were 38 (38/136, 27.9%) patients who had concurrent endometriosis. The recurrence rate was 41.9% (40/136). Univariate analysis showed that the FIGO staging, concurrent endometriosis, lymphatic metastasis, residual tumor diameter, sufficient chemotherapeutic cycles and progression free survival (PFS) (all P<0.05) were prognostic factors, while age of patients at diagnosis, peritoneal cytological status, tumor diameter and different chemotherapy regimes (all P>0.05) were not. Cox multivariate analysis showed that PFS was an inde-pendent prognostic factor for OCCA (P<0.05). Conclusion Our results suggest that optimal cytoreductive surgery and sufficient postoperative chemotherapy can improve the prognosis of patients with OCCA.