Jenison E L, Montag A G, Griffiths C T, Welch W R, Lavin P T, Greer J, Knapp R C
Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Gynecol Oncol. 1989 Jan;32(1):65-71. doi: 10.1016/0090-8258(89)90852-4.
Forty-four patients with clear cell adenocarcinoma of the ovary diagnosed between 1944 and 1981 were compared with a matched cohort of 55 patients with the most common epithelial malignant lesion, serous adenocarcinoma, in terms of their presentation and clinical course. None were lost to follow-up. Median follow-up was 9 years. Fifty percent of clear cell patients presented in Stage I versus 31% of serous patients. Patients with clear cell carcinoma presented more often with pelvic masses (84% vs 65%) and had larger (diameter greater than 10 cm) primary tumors (73% vs 29%). Forty-nine percent of clear cell patients were nulligravid compared with 24% of serous patients and endometriosis was strikingly more common in clear cell patients (58% vs 12%). When compared stage for stage, clear cell tumors were uniformly associated with poorer 5-year survival rates with an overall rate of 34%. In patients with recurrent disease, lymph node involvement was much more common in patients with clear cell carcinoma (40% vs 7%). Parenchymal organ involvement was also more common in the clear cell group (40% vs 13%). Ovarian clear cell adenocarcinoma has distinctly different clinical behavior compared to serous carcinoma and should be regarded as an aggressive epithelial histologic type.
对1944年至1981年间诊断出的44例卵巢透明细胞腺癌患者与55例患有最常见上皮恶性病变即浆液性腺癌的匹配队列患者的临床表现和临床病程进行了比较。无一例失访。中位随访时间为9年。50%的透明细胞癌患者为I期，而浆液性癌患者为31%。透明细胞癌患者更常出现盆腔肿块（84%对65%），且原发肿瘤更大（直径大于10厘米）（73%对29%）。49%的透明细胞癌患者未孕，而浆液性癌患者为24%，且子宫内膜异位症在透明细胞癌患者中明显更常见（58%对12%）。逐期比较时，透明细胞肿瘤的5年生存率均较低，总体生存率为34%。在复发疾病患者中，透明细胞癌患者的淋巴结受累更为常见（40%对7%）。实质器官受累在透明细胞组中也更常见（40%对13%）。与浆液性癌相比，卵巢透明细胞腺癌具有明显不同的临床行为，应被视为一种侵袭性上皮组织学类型。
