摘要
目的探讨卵巢型子宫内膜异位症(EMs)恶变为卵巢癌的危险因素。方法收集2010-01-01-2021-10-31在潍坊市人民医院接受手术治疗且术后病理确诊为EMs相关卵巢癌(EAOC)患者37例及术后病理为EMs患者168例的临床病历资料。以37例EAOC为EAOC组,168例EMs为对照组,采用病例-对照研究方法,回顾性分析与EAOC有关联的临床特点及危险性因素。结果37例EAOC患者中,病理类型为透明细胞癌23例(62.16%),子宫内膜样癌14例(37.84%);Ⅰ期34例(91.89%),Ⅱ期3例(8.11%)。多因素回归分析结果显示,年龄(OR=1.113,95%CI为1.017~1.218)、血清人附睾蛋白-4(OR=1.027,95%CI为1.003~1.052)、D二聚体(OR=2.142,95%CI为1.073~4.272)、肿物最大直径(OR=1.310,95%CI为1.023~1.678)和血流信号(OR=3.974,95%CI为1.193~13.239)均为EAOC的独立影响因素,且均为独立危险因素,均P<0.05。结论对于围绝经期卵巢型EMs患者,卵巢肿物直径>9 cm,存在较丰富的血流信号,合并血清人附睾蛋白-4、D二聚体水平升高,其恶变风险明显增高,需严密随访并积极干预。
Objective To investigate the risk factors of malignant transformation of ovarian cancer in ovarian endometriosis(EMs).Methods The clinicopathological characteristics of 37 endometriosis-associated ovarian cancer(EAOC) patients and 168 EMs patients, who received surgery and were pathological diagnosis in Weifang People’s Hospital between January 1, 2010 and October 31, 2021. By using case control study method, the clinical characteristics and risk factors associated with EAOC were analyzed retrospectively with 37 cases as EAOC indicator case group and 168 EMs as indicator control group. Results Among the 37 EAOC patients, 23 cases(62.16%) were pathologically diagnosed with clear cell carcinoma, and 14 cases(37.84%) were endometrioid carcinoma. There were 34 patients(91.89%) in stage Ⅰ, 3 patients(8.11%) in stage Ⅱ. Multivariate regression analysis showed that age(OR=1.113,95%CI:1.017-1.218), HE4(OR=1.027,95%CI:1.003-1.052), D dimer(OR=2.142,95%CI:1.073-4.272), maximum diameter of tumor(OR=1.310,95%CI:1.023-1.678), blood flow signal(OR=3.974,95%CI:1.193-13.239) were all independent influencing factors of EAOC,and were all independent risk factors(P<0.05).Conclusion For perimenopausal patients with ovarian EM, the ovarian tumor with a diameter of more than 9 cm, abundant blood flow signals, and the increase of HE4 and D dimer levels indicate an increased risk of malignancy, which requires close follow-up and active intervention.
作者
陈福健
刘学良
刘欣
CHEN Fujian;LIU Xueliang;LIU Xin(Department of Obstetrics and Gynecology.Wei fang Medical University,Weifang 261053,China;Department of Gynecology,Weifang Peoples Hospital,Weifang 261044.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第7期419-423,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
子宫内膜异位症
恶变
卵巢癌
危险因素
endometriosis
malignant transformation
ovarian cancer
risk factors
