Kikkawa Fumitaka, Nawa Akihiro, Kajiyama Hiroaki, Shibata Kiyosumi, Ino Kazuhiko, Nomura Seiji
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Gynecol Oncol. 2006 Oct;103(1):171-5. doi: 10.1016/j.ygyno.2006.02.015. Epub 2006 Mar 20.
Ovarian mucinous tumors consist of benign, borderline, and carcinomatous tumor, but the clinical characteristics of these 3 types have not been investigated in detail. In this study, we compared the clinical characteristics and prognosis among these 3 types of mucinous tumors.
One hundred sixty-one patients with mucinous cystadenocarcinoma and 143 patients with mucinous borderline tumor were registered between 1986 and 2003. All patients were reviewed by two pathologists, then the mixed type and cases showing other organized malignant tumors were excluded from this study. Patients with mucinous carcinoma staged Ib or more were treated postoperatively with 6 cycles of platinum-based chemotherapy. Survival probability was analyzed by the Kaplan-Meier method and differences in survival rates were calculated using log-rank test.
Mean patient ages were 43.9, 44.7, and 49.7 years in patients with benign, borderline, carcinomatous tumor, respectively. The ratio of early stage (I, II) to advanced stage (III, IV) was significantly lower in carcinoma than in borderline tumor. The levels of tumor markers tended to increase with the level of malignancy. CA72-4 is the most useful discriminating marker according to ROC analysis. In borderline tumor, 5 patients died of disease, and all of these patients had stage III disease with residual tumor after the initial surgery. Patients with borderline tumor showed significantly better prognosis than those with carcinoma; however, there were no significant differences in prognosis between borderline tumor and carcinoma in patients with stage III tumor or residual tumor.
In mucinous tumors, measurement of CA72-4 is recommended to distinguish malignant from benign tumors. Even in borderline tumor, patients with residual tumor showed a poorer prognosis than carcinoma, suggesting that complete resection is necessary for a good prognosis.
卵巢黏液性肿瘤包括良性、交界性和癌性肿瘤，但这三种类型的临床特征尚未得到详细研究。在本研究中，我们比较了这三种类型黏液性肿瘤的临床特征和预后。
1986年至2003年间登记了161例黏液性囊腺癌患者和143例黏液性交界性肿瘤患者。所有患者均由两名病理学家进行复查，然后将混合型和显示其他有组织恶性肿瘤的病例排除在本研究之外。黏液癌分期为Ib期或更高的患者术后接受6个周期的铂类化疗。采用Kaplan-Meier法分析生存概率，并使用对数秩检验计算生存率差异。
良性、交界性、癌性肿瘤患者的平均年龄分别为43.9岁、44.7岁和49.7岁。癌性肿瘤早期（I、II期）与晚期（III、IV期）的比例显著低于交界性肿瘤。肿瘤标志物水平倾向于随着恶性程度的升高而升高。根据ROC分析，CA72-4是最有用的鉴别标志物。在交界性肿瘤中，5例患者死于疾病，所有这些患者均为III期疾病，初次手术后有残留肿瘤。交界性肿瘤患者的预后明显优于癌性肿瘤患者；然而，III期肿瘤或有残留肿瘤的患者中，交界性肿瘤和癌性肿瘤的预后无显著差异。
在黏液性肿瘤中，建议检测CA72-4以区分良性和恶性肿瘤。即使在交界性肿瘤中，有残留肿瘤的患者预后也比癌性肿瘤患者差，这表明完全切除对于良好的预后是必要的。
