子宫内膜异位症相关性卵巢透明细胞癌和卵巢子宫内膜样癌的临床病理特征研究

目的 研究子宫内膜异位症(EM)相关性卵巢透明细胞癌(CCC)和卵巢子宫内膜样癌(EC)的临床病理特征.方法 选取CCC和EC患者共167例,根据是否为EM恶变将患者分为EM组(n=84)和非EM组(n=83).比较两组患者的年龄、生育史、EM病史、临床表现、凝血功能、血清CA125水平、超声检查结果、术中情况及术后病理特点.结果 EM组患者的发病年龄、初潮年龄均明显小于非EM组(P﹤0.01),未绝经患者所占比例明显低于非EM组(P﹤0.01);EM组患者的孕次、产次明显低于非EM组(P﹤0.001),不孕症患者所占比例明显高于非EM组(P﹤0.001);EM组中既往有EM病史的患者所占比例高于非EM组(P﹤0.05);临床表现方面,EM组患者的痛经、月经紊乱发生率均明显高于非EM组(P﹤0.01);EM组患者的PT、APTT明显短于非EM组(P﹤0.001);术后,EM组患者的血清CA125水平低于非EM组(P﹤0.05);两组患者超声检查结果比较,差异无统计学意义(P﹥0.05);EM组患者的肿瘤直径明显大于非EM组(P﹤0.001);两组患者的FIGO分期比较,差异有统计学意义(P﹤0.05),其中EM组患者中Ⅰ~Ⅱ期患者所占比例高于非EM组.结论 EM相关性CCC和EC与单纯CCC和EC存在明显不同的临床病理特征,具有确诊年龄及初潮年龄小、绝经比例更高、孕产次更低、既往有EM病史患者所占比例更高、痛经和月经紊乱表现更多、PT和APTT更短、血清CA125水平较低和临床病理分期较早等特点.

Clinicopathological features of endometriosis-associated ovarian clear cell carcinoma and ovarian endometrioid carcinoma

Objective To study the clinicopathological features of endometriosis (EM)-associated ovarian clear cell carcinoma (CCC) and ovarian endometrioid carcinoma (EC). Method A total of 167 cases of CCC and EC patients were included in the study, stratification were performed based on patients with (EM group, n=84) or without (non EM group, n=83) malignant transformation of EM, of which the age, reproductive history, history of EM, clinical manifestations, blood coagulation function, serum CA125 level, ultrasound findings, intraoperative and postoperative pathological charac-teristics were compared. Result Patients in EM group had lower age of onset, and age at menarche than non EM group (P<0.01), with lower proportion of premenopausal patients (P<0.01), less gravidity and parity (P<0.001), higher rate of in-fertility (P<0.001), more patients with a history of EM (P<0.05) compared with non EM group;as for clinical manifesta-tions, higher incidence of dysmenorrhea, menstrual disorders (P<0.01), and shorter PT and APTT (P<0.001) were ob-served in EM group compared with non EM group;after surgery, the serum level of CA125 was lower in EM group than that of non EM group (P<0.05); while the ultrasound findings were comparable between the two groups (P>0.05); EM group had larger tumor diameter than non EM group (P<0.001); and the difference of FIGO staging between the two groups was statistically significant (P<0.05), in which the proportion of patients with stage Ⅰ-Ⅱwas lower in EM group than that in non EM group. Conclusion The clinicopathological features of EM associated CCC and EC were different with that of simple CCC and EC, with the characteristics of lower age at diagnosis and age at menarche, higher proportion of menopause, less gravidity and parity, more patients with history of EM, higher rate of dysmenorrhea and menstrual dis-orders, shorter PT and APTT, lower levels of serum CA125 and lower clinical stage.