Kucukgoz Gulec Umran, Paydas Semra, Guzel Ahmet Baris, Vardar Mehmet Ali, Khatib Ghanim, Gumurdulu Derya
Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, 01330, Adana, Turkey,
Arch Gynecol Obstet. 2015 Oct;292(4):923-9. doi: 10.1007/s00404-015-3699-9. Epub 2015 Apr 9.
This study aimed to compare the clinical characteristics and outcomes of the cases with pure ovarian clear cell adenocarcinoma (OCCC), mixed type (clear plus serous or clear plus endometrioid or serous plus clear plus endometrioid) ovarian adenocarcinoma (MOC) and high-grade serous ovarian adenocarcinoma (HGSOC).
A retrospective comparison was conducted in 32 cases with pure OCCC, 23 cases with MOC and 28 cases with HGSOC followed between January 1999 and October 2011. Clinico-pathologic characteristics including histopathologic subtypes, age, stage, presence of ascites and/or peritoneal carcinomatosis, endometriosis and optimal cytoreduction, and also survival rates were compared in these three groups.
The cases with pure OCCC were younger than the cases with MOC and HGSOC (p = 0.004). The median pre-operative CA-125 level was lower in the pure OCCC than in MOC and HGSOC (p = 0.006) (p = 0.001, p = <0.001, respectively). Bilaterality and peritoneal carcinomatosis were more frequently seen in the HGSOC group (p = 0.001, p < 0.001, respectively). The majority of the cases (65 %) had stage I or II disease in the pure OCCC group, but most of the cases in the HGSOC group had advanced stage disease (p < 0.001). Endometriosis was found in 16 cases (16/55, 29 %) in the OCCC group. No significant difference was detected with regard to the median survival rate among three groups (p = 0.517), while the stage of disease was found to be the only important factor for survival (p = 0.002).
Pure OCCC, MOC and HGSOC represent distinct clinical characteristics. Clinical characteristics of MOC are more similar to those of HGSOC.
本研究旨在比较单纯性卵巢透明细胞腺癌（OCCC）、混合型（透明细胞加浆液性或透明细胞加子宫内膜样或浆液性加透明细胞加子宫内膜样）卵巢腺癌（MOC）和高级别浆液性卵巢腺癌（HGSOC）的临床特征及预后。
对1999年1月至2011年10月期间随访的32例单纯性OCCC、23例MOC和28例HGSOC患者进行回顾性比较。比较这三组患者的临床病理特征，包括组织病理学亚型、年龄、分期、腹水和/或腹膜种植转移、子宫内膜异位症及最佳肿瘤细胞减灭术情况，以及生存率。
单纯性OCCC患者比MOC和HGSOC患者年轻（p = 0.004）。单纯性OCCC患者术前CA-125水平中位数低于MOC和HGSOC患者（p = 0.006）（分别为p = 0.001，p < 0.001）。双侧性和腹膜种植转移在HGSOC组更常见（分别为p = 0.001，p < 0.001）。单纯性OCCC组大多数病例（65%）为Ⅰ期或Ⅱ期疾病，而HGSOC组大多数病例为晚期疾病（p < 0.001）。OCCC组有16例（16/55，29%）发现子宫内膜异位症。三组患者的中位生存率无显著差异（p = 0.517），而疾病分期是生存的唯一重要因素（p = 0.002）。
单纯性OCCC、MOC和HGSOC具有不同的临床特征。MOC的临床特征与HGSOC更相似。
