【摘要】 目的:分析FIGO Ⅰ期单纯型卵巢透明细胞癌患者的临床病理特点，探寻预后影响因素。方法:回顾分析2010年1月至2019年10月在天津市中心妇产科医院就诊并接受手术治疗的94例Ⅰ期单纯型卵巢透明细胞癌患者的病例资料。应用Kaplan-Meier单因素分析筛选预后相关危险因素，并用Cox比例风险模型进行多因素分析发掘影响预后的独立因素，总结其临床预后特点。结果:94例患者平均发病年龄52岁，均行卵巢癌全面分期手术。中位随访时间58.3个月(13～119个月),8例复发，5例死亡。患者5年生存率93.2%,3年无进展生存率94.1%。腹腔镜分期术患者的5年生存率显著低于开腹分期术患者(75.2%vs 94.6%,P=0.008),p53阳性患者的5年生存率显著低于p53阴性患者(80.2%vs 93.4%,P=0.03)。由于总生存的终点事件较少，无法行Cox多因素分析。结论:Ⅰ期卵巢透明细胞癌肿物大，生长慢，预后好，手术途径及p53对Ⅰ期卵巢透明细胞癌的预后具有重要价值。对于Ⅰ期卵巢透明细胞癌，腹腔镜分期手术的肿瘤学安全性尚不确定，应综合评估患者情况及肿瘤破裂风险后谨慎使用。更多还原

【Abstract】 Objective:To investigate the clinicopathological characteristics and prognostic factors of FIGO stage Ⅰ ovarian pure clear cell carcinoma.Methods:94 cases of stage Ⅰ ovarian pure clear cell carcinoma after surgical treatment between January 2010 and October 2019 were retrospectively analyzed.Kaplan-Meier univariate analysis and Cox proportional risk model were employed to analyze the prognostic factors.Results:The average age at diagnosis was 52 years old.The median follow-up time was 58.3 months(range 13～119 months),with 8 recurrences and 5 deaths.The 5-year overall survival rate and the 3-year progression-free survival rate was 93.2% and 94.1%,respectively.The 5-year survival rate of patients with laparoscopic staging was significantly lower than that of patients with open staging(75.2% vs 94.6%,P=0.008),and the 5-year survival rate of patients with positive p53 was significantly lower than that of patients with negative p53(80.2% vs 93.4%,P=0.03).Cox multivariate analysis could not be performed due to the small number of endpoint events of overall survival.Conclusion:Most of stage Ⅰ ovarian pure clear cell carcinomas were complicated with huge slow-growing adnexal masses.The prognosis of the patients was good.The operation approach and p53 would contribute to the prognosis of stage Ⅰ ovarian pure clear cell carcinoma.The oncological safety of laparoscopic staging surgery was uncertain.This technique should be performed cautiously considering the overall patient situation and the risk of tumor rupture.更多还原