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卵巢子宫内膜异位症恶性变25例临床分析

更新时间:2012-04-21 13:23:12  
钱建华 石一复 陈晓端 赵承洛

  【摘要】 目的 探讨卵巢子宫内膜异位症恶性变的临床表现、病理特征、治疗方法和预后。方法 回顾性分析25例卵巢子宫内膜异位症恶性变患者的临床和病理资料。结果 卵巢子宫内膜异位症恶性变患者的主要症状为盆腔包块、腹胀、腹痛、异常阴道流血和流液。病理类型为子宫内膜样癌14例,透明细胞癌2例,腺棘癌2例,浆液性腺癌1例,混合性卵巢上皮性癌6例,镜下均可见良性的异位子宫内膜向恶性移行的证据。临床分期为 Ⅰ期14例,Ⅱ期7例,Ⅲ期3例,Ⅳ期1例。治疗方法均采用肿瘤细胞减灭术+化学治疗。患者5年生存率达77.7%。结论 卵巢子宫内膜异位症恶性变的确切发生率难以估计,该病的治疗以肿瘤细胞减灭术+化学治疗为主。
  【关键词】 子宫内膜异位症; 卵巢

Clinical Analysis of 25 Cases of Malignant Transformation of Endometriosis of the Ovary

QIAN Jianhua, SHI Yifu, CHEN Xiaoduan, et al
(Department of Obstetrics and Gynecology, Affiliated Obstetrics and Gynecology Hospital,Faculaty of Medicine Zhejiang University, Hangzhou 310006, China)

  【Abstract】 Objective To study clinicopathologic characteristics, treatment and prognostic factors of malignant transformation of endometriosis of the ovary. Methods From 1981 to 1999, a total of 25 patients with malignant transformation of endometriosis of the ovary were retrospectively analyzed. Results The main symptoms were pelvic masses,abdominal pain, abdominal distension and abnormal vaginal bleeding or discharge. Histological type: of the 25 cases, 14 were endometrioid carcinomas, 2 were clear-cell carcinomas, 2 were adenoacanthoma, 1 was serous papillary adenocarcinomas, 6 were mixed epithelium tumor of ovary. The exact area of histologic transition from benign to malignant epithelium was observed in 25 patients. Stage: stage Ⅰ 14, stage Ⅱ 7, stage Ⅲ 3, stage Ⅳ 1. The actual 5 -year survival rate was 77.7%. Conclusions The exact incidence and prevalence of malignant transformation in endomrtriosis is unknown. Radical tumor resection combined with chemotherapy is the main therapeutic approach for malignant transformation of endometriosis of the ovary.
  【Key words】 Endometriosis; Ovary

  卵巢子宫内膜异位症(内异症)是妇科的常见病和多发病。卵巢内异症一般是良性过程,但是种种迹象表明,卵巢内异症有恶性变潜能,卵巢内异症可能是部分或全部卵巢子宫内膜样癌和透明细胞癌的癌前病变[1]。1925年,Sampson[2]首先报道卵巢内异症恶性变现象。随后, 国外有不少有关卵巢内异症恶性变的报道,但国内相关报道并不多见。我们根

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