天津医药

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单纯子宫内膜异位症与合并卵巢癌的临床分析

宋誌   

  1. 天津市中心妇产科医院
  • 收稿日期:2010-02-05 修回日期:2010-07-21 出版日期:2010-10-15 发布日期:2010-10-15
  • 通讯作者: 宋誌

Clinical analysis of Endometriosis and Endometriosis conbined with Ovarian Cancer

  • Received:2010-02-05 Revised:2010-07-21 Published:2010-10-15 Online:2010-10-15

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摘要： 摘要 目的：探讨子宫内膜异位症（endometriosis，EM）的病理特点及卵巢癌的相关危险因素。方法：回顾性分析我院2000—2005年4234例经手术治疗并经病理确诊为卵巢子宫内膜异位囊肿及合并卵巢癌患者的临床资料。结果：将患者依据病理诊断分为两组，A组：单纯子宫内膜异位症组，B组：子宫内膜异位症合并卵巢癌组。A组以经期腹疼、月经改变为主诉的比例较高（81.8%），B组主诉主要是腹胀，盆腔肿物（χ2=56.88，P<0.01）。A组B超检查肿物直径＞8 cm和或伴实质性包块2041例（49.5%），B组中41例肿物直径>8cm(73.2%)，差异具有统计学意义（P<0.01）。A组年龄<40岁者2953例（71.6%），B组中年龄<40岁有19例（33.9%），差异具有统计学意义（P<0.01）。术前CA125>100U/ml者A组357例（8.7%），B组15例（26.8%）。随访5年，A组5年生存率为92.4%，B组为46.9%，差异有统计学意义（P<0.01）。结论：对于有高危因素的EM患者,如B超检查肿物直径＞8 cm和或伴实质性包块，CA125>100U/ml，应给予积极手术治疗，及早发现合并卵巢癌患者。临床工作中，应高度重视EM合并卵巢癌问题。

关键词: 子宫内膜异位症, 卵巢肿瘤, 预后, 恶变, 五年存活率

Abstract: Abstract Objective：To discuss the pathological feather and correlated risk factor of malignant of endometriosis．Methods：4234 endometriosis cases from 2000 to 2005 were analyzed retrospectively, Surgical treatment and pathological examination confirmed endometriosis．Results：Patients were divided into two groups based on pathological diagnosis.Dysmenorrhea and alter of menses were more frequent in group A（81.8%）, abdominal distension and mass of pelvic cavity were more frequent in group B（χ2=56.88，P<0.01）. There were 2041 diameter of tumor in group A in 4178 cases exceed 8cm(49.5%)，diameter of tumor of 41 cases of group B exceed 8cm (73.2%), the distinction has statistical significance (P< 0.01) . Beyond surgry 357 cases’s value of CA125 is higher than 100U/ml in group A（8.7%），15 cases’s value of CA125 is higher than 100U/ml in group B（26.8%）。Age of 2953 cases in group A less than 40(71.6%）, age of 19 cases in group B less than 40(33.9%）, the distinction has statistical significance (P< 0.01) . Makes a follow-up visit for 5 years, five year survival rate of pure ovarian cancer of group A is 92.4%, group B is 46.9%. Condiusion：Patients with risk factors of diameter of tumor exceed 8cm or CDFI accompanied by substantial mass or CA125 is higher than 100U/ml ,surgical treatment is used for patients with risk factor,so to find the patients who was conbined with ovarian cancer.So we shoule pay higher attention to it in the linical work.

Key words: Endometriosis Ovarian neoplasms Prognosis Malignant Five year survival rate