53例卵巢透明细胞癌的临床特点和预后因素分析

目的探讨卵巢透明细胞癌（OCCC）的临床特点和预后因素分析。方法回顾性分析1990年1月-2007年12月53例原发性卵巢透明细胞癌患者临床资料,对其临床特点与治疗情况进行总结并分析其预后。结果 53例卵巢透明细胞癌占本院同期卵巢上皮癌的4.3%,Ⅰ期患者23例,5年生存率43.48%;Ⅱ期患者15例,5年生存率26.67%;两者比较有统计学差异（P=0.016）;Ⅰ-Ⅱ期5年生存率36.84%;Ⅲ期患者15例,5年生存率28.67%,两者比较有统计学差异,P=0.01。Ⅰ＋Ⅱ期患者理想/不理想的肿瘤细胞减灭术5年生存率分别为40%/0;Ⅲ期理想/不理想的肿瘤细胞减灭术5年生存率20%/0,差异有显著性（P〈0.02、P〈0.03）。手术＋化疗＋生物治疗组与手术＋化疗组5年生存率比较无统计学差异,P=0.43;手术＋化疗＋放疗组的5年生存率50%,与手术＋化疗组相比较有统计学意义,P=0.02。结论卵巢透明细胞癌临床分期早,但预后差,影响预后的因素为临床分期、是否行理想的肿瘤细胞减灭术及治疗方式。术后联合放疗、生物治疗,可望改善预后。

Clinical characteristics and prognosis of 53 patients with clear cell carcinoma of ovary

Objective This study was to study the clinical characteristics and the prognosis of clear cell carcinoma of the ovary. Methods Fifty-three patients with ovarian clear cell carcinoma who were treated from Jan 1990 to Dec 2007 were studied retrospectively. Through following up,we can conclude the clinical character and the relative treatment of the OCCC, so as to analysis the prognosis. Results OCCC is an incidence of 4.3% of all ovarian malignancies of our hospital. In a series of 53 OCCC patients, found 23 stage I who has higher 5-survival rate than that of the 15 stage II patients（P=0.016）. 5-survival rate of stage Ⅰ-Ⅱ/Ⅲ was 36.84%, 28.67% respectitively（P=0.01）, The 5-survival rate of the stage I -Ⅱ patients who accept the optimal cytreductive surgery and unoptimal cytreductive surgery was sepectively 40%/0, whereas stage Ⅲ patients, was sepectively 20%/0（P〈0.02, P〈0.03）. The 5-survival rate of the patients who accept radiotherapy after the optimal cytreductive surgery and chemotherapy was 50%, which was higher than that of the patients who only accept the surgery and chemotherapy（P=0.02）. Conclusion OCCC has poor prognosis and its stage was early, The factors effecting the prognosis of OCCC were clinical stage, optimal cytreductive surgery and treatment ways. Postoperative radiotherapy or/and biotherapy could have better results and improve the prognosis of O C C C.