Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
Gynecol Oncol. 2011 Sep;122(3):541-7. doi: 10.1016/j.ygyno.2011.05.009. Epub 2011 Jun 2.
To compare the survival outcome between clear cell carcinoma (CCC) and other histological subtypes in epithelial ovarian carcinoma (EOC).
From January 1974 to February 2011, we identified a total of 31,800 (CCC; 2152, non-CCC; 29648) patients from 12 studies meeting the inclusion criteria.
Heterogeneity tests demonstrated significant between-study variation (I(2)=92.1%) with no significant difference in hazard ratio (HR) for death between CCC and non-CCC (HR; 1.16, 95% CI; 0.85-1.57, random-effects model). Comparing the HR based on stage I+II, and stage III+IV, between CCC and non-CCC, showed that CCC patients had a higher hazard rate for death than those with non-CCC of the ovary (stage I+II; HR; 1.17, 95% CI; 1.01-1.36, stage III+IV; HR; 1.65, 95% CI; 1.52-1.79). In a comparison of CCC and serous EOC, advanced stage (III and IV) CCC only showed a poorer hazard rate for death than serous EOC (HR; 1.71, 95% CI; 1.57-1.86).
This analysis suggests that ovarian CCC patients had poorer prognosis than those with other histological subtypes of EOC, especially in advanced EOC stages. Different treatment strategies may be needed for patients with ovarian CCC.
比较上皮性卵巢癌（EOC）中透明细胞癌（CCC）与其他组织学亚型的生存结局。
我们从 1974 年 1 月至 2011 年 2 月共从符合纳入标准的 12 项研究中确定了 31800 例患者（CCC：2152 例，非 CCC：29648 例）。
异质性检验显示研究间存在显著差异（I²=92.1%），但 CCC 和非 CCC 之间的死亡风险比（HR）无显著差异（HR：1.16，95%CI：0.85-1.57，随机效应模型）。比较 CCC 和非 CCC 基于 I 期+II 期和 III 期+IV 期的 HR 显示，CCC 患者的死亡风险高于非 CCC 卵巢癌患者（I 期+II 期：HR：1.17，95%CI：1.01-1.36；III 期+IV 期：HR：1.65，95%CI：1.52-1.79）。在 CCC 和浆液性 EOC 的比较中，仅晚期（III 和 IV 期）CCC 显示出比浆液性 EOC 更差的死亡风险（HR：1.71，95%CI：1.57-1.86）。
本分析表明，与其他组织学类型的 EOC 相比，卵巢 CCC 患者的预后较差，尤其是在晚期 EOC 阶段。可能需要为卵巢 CCC 患者制定不同的治疗策略。
