【作者】 热娜；

【导师】 艾星子·艾里；

【作者基本信息】 新疆医科大学 ， 妇产科学， 2011， 硕士

【摘要】 目的：卵巢子宫内膜异位症(EM)是常见妇科良性疾病,异位的子宫内膜同原位的子宫内膜,均具有潜在的恶性可能。本研究通过对卵巢EM恶变、卵巢恶性肿瘤合并EM及未合并EM的卵巢恶性肿瘤病例的分析,了解卵巢EM恶变在临床发病情况及其与原发性卵巢恶性肿瘤的关系。方法：回顾性分析我院2003年1月至2010年12月就诊并经病理确诊的原发性卵巢恶性肿瘤共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,除外A组患者,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。同期本院经手术确诊的卵巢EM患者共1946例。结果：卵巢EM恶变的发生率0.87%(17/1946),为卵巢恶性肿瘤的4.7%(17/362)。原发性卵巢恶性肿瘤合并EM 16例,发生率为4.4%(16/362)；从一般特征上分析,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9cm,且CA125水平多在200U/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,与卵巢透明细胞癌和子宫内膜样癌有一定关系,EM可能是一些早期卵巢上皮性癌的病因,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。更多还原

【Abstract】 Objective:0varian endometriosis is a common and benign, but progressive disease. The investigate to exp lore the relationship between ovarian cancer and endometriosis by analyzing the cases of ovary cancer with endometriosis. Methods:Two hundred and twenty-two primary ovarian cancer cases from 2003.1 to 2010.12 were analyzed retrospectively, compared. Among the 362 cases.17 were found to originate from endometriosis(group A),16 were found to have CO-existing ovarian endometriosis(group B)。and the remaining 329 had no ovarian endometriosis at all(group C). Results:Seven hundred and twenty-seven epithelial ovarian carcinoma patients were identified and their elinicopathological data retrieved, There were 17 cases of ovarian cancer with endometriosis(0.87%)in all cases. The major initial manifestation was pelvic masses. The incidence of pathologyⅡstage in group A、B was 70.6% and 56.2%, pathology III stage in group C was 47.7%. Three groups having subtype of serous carcinoma. Conclusion:The diagnosis of malignant change of endometriosis maybe associated with the degree、classification of ovary cancer, Patients of endometriosis-associated epithelial ovarian carcinoma, especially patients with tumors arising from endometriosis, were found to be younger, having a better survival. and were mostly diagnosed with the subtype of clear-cell and endometrio-carcinoma, There is a compact relationship between endometriosis and ovarian cancer, especially the types of clear cell carcinoma and endometrio-carcinoma, the malignant change of endometriosis.更多还原