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目的卵巢子宫内膜异位症(EM)是常见的妇科良性疾病,具有潜在的恶变可能。本研究通过对卵巢EM恶变、合并EM及未合并EM的卵巢恶性肿瘤病例的分析,了解卵巢EM恶变与卵巢恶性肿瘤的关系。方法 回顾性分析新疆医科大学第一附属医院2003年1月至2010年12月经病理确诊的原发性卵巢恶性肿瘤患者共362例,根据卵巢EM恶变诊断标准及病理结果,将EM恶变的17例患者分为A组,其他仅合并卵巢EM的卵巢恶性肿瘤16例患者分为B组,未合并卵巢EM的卵巢恶性肿瘤329例为C组,从卵巢恶性肿瘤的临床病理资料对三组进行对照分析。同期在本院经手术确诊的卵巢EM患者共1 946例。结果A、B组临床症状多以腹痛为主,其次为盆腔包块;从临床分期来看,A、B组以Ⅱ期居多,分别占70.6%、56.5%,C组以Ⅲ期为多,占47.7%;从组织类型来看,A、B组多为透明细胞癌(分别为70.6%、56.2%),而C组则以浆液性腺癌(50.2%)为主。三组在一般特征、临床分期及病理组织分类的分布差异均有统计学意义。结论卵巢EM恶变的临床症状以腹痛为多,其次为盆腔包块,肿块直径超过9 cm,且CA125水平多在200 U/ml以上;卵巢EM恶变及卵巢恶性肿瘤合并EM病例中早期患者比例较高,具有年轻化(尤其是卵巢内异症恶变患者)的特点,且多为卵巢透明细胞癌和子宫内膜样癌;卵巢EM恶变的诊断与组织病灶程度、临床分期可能有关,卵巢EM病灶恶变可能来源于透明细胞癌和子宫内膜样癌,因此卵巢EM可被认为是卵巢恶性肿瘤的危险因素。
Objective Ovarian endometriosis (EM) is a common gynecological benign disease, with potential malignant potential. In this study, ovarian EM malignant transformation, combined EM and EM ovarian cancer cases were analyzed to understand the relationship between ovarian EM malignant and ovarian cancer. Methods A retrospective analysis of the First Affiliated Hospital of Xinjiang Medical University from January 2003 to December 2010 by pathology confirmed a total of 362 cases of patients with primary ovarian cancer, EM ovarian malignancy according to the diagnostic criteria and pathological findings, 17 cases of EM malignant transformation The patients were divided into group A and other ovarian malignancies with ovary EM only. Sixteen patients were divided into group B, 329 cases of ovarian malignancy without EM and 329 cases of group C, and the clinical and pathological data of ovarian cancer were compared to the three groups analysis. Over the same period in our hospital diagnosed ovarian EM patients a total of 1 946 cases. Results The clinical symptoms in group A and group B were mainly abdominal pain, followed by pelvic mass. According to the clinical stage, group A and group B were predominant in stage Ⅱ, accounting for 70.6% and 56.5% respectively, while those in group C were mostly stage Ⅲ, Accounting for 47.7%. According to the type of tissue, most of the patients in group A and B were clear cell carcinoma (70.6% and 56.2% respectively), while those in group C were mainly serous adenocarcinoma (50.2%). Three groups in the general characteristics, clinical stage and histological classification of the distribution differences were statistically significant. Conclusions The clinical symptoms of ovarian EM are mainly abdominal pain, followed by pelvic mass, the diameter of tumor is more than 9 cm, and the CA125 level is more than 200 U / ml. The proportion of EM in malignant ovarian tissue and early stage ovarian cancer with EM is higher High, with younger (especially patients with malignant ovarian endometriosis), and most of ovarian clear cell carcinoma and endometrioid carcinoma; ovarian EM malignant diagnosis and tissue lesions, clinical stage may be related to ovarian EM lesions Malignant tumors may come from clear cell carcinoma and endometrioid carcinoma, ovarian EM can be considered as a risk factor for ovarian cancer.