He Z X, Wang S, Li Z F, Zhu L, Leng J H, Lang J H
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2017 May 25;52(5):314-319. doi: 10.3760/cma.j.issn.0529-567X.2017.05.005.
To explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis aged 45 years and older in China. The medical records of total 1 038 women aged 45 years and older with a surgicopathological diagnosis of ovarian endometriosis treated at Peking Union Medical College Hospital from December 1994 to December 2014 were reviewed. Histology evaluation determined ovarian endometriosis with (=30) or without (=1 008) ovarian cancer. (1) There were 30 (2.9%, 30/1 018) cases confirmed as having EAOC. Clear cell carcinoma (63.3%, 17/30) and endometrioid adenocarcinoma (23.3%, 7/30) were commonly observed subtypes and 70.0% of EAOC patients were at stage Ⅰ. (2) Compared women with ovarian endometriosis in the same age group, patients with EAOC were older (50.8 vs 48.5 years, =0.002). There were more in postmenopausal status at diagnosis of EAOC (<0.01). There were more found with a mass ≥8 cm (<0.01). Women with EAOC had higher prevalence of coexisting endometrial disorders (=0.003). No differences were found in preoperative CA(125) value and infertile or nulliparous women (>0.05). For women with ovarian endometriosis aged 45 years and older, the subgroup of patients characterized by postmenopausal status and ovarian endometrioma (≥8 cm) have a higher risk of EAOC. Active intervention or intensive follow-up should be considered for this population group, especially for those concurrent with endometrial disorders.
探讨中国45岁及以上卵巢子宫内膜异位症女性发生子宫内膜异位症相关卵巢癌(EAOC)的危险因素。回顾了1994年12月至2014年12月在北京协和医院接受手术病理诊断为卵巢子宫内膜异位症的1038例45岁及以上女性的病历。组织学评估确定有(=30)或无(=1008)卵巢癌的卵巢子宫内膜异位症。(1)有30例(2.9%,30/1018)确诊为EAOC。透明细胞癌(63.3%,17/30)和子宫内膜样腺癌(23.3%,7/30)是常见的亚型,70.0%的EAOC患者处于Ⅰ期。(2)与同年龄组的卵巢子宫内膜异位症女性相比,EAOC患者年龄更大(50.8岁对48.5岁,=0.002)。EAOC诊断时绝经后状态的患者更多(<0.01)。发现肿块≥8 cm的患者更多(<0.01)。EAOC女性共存子宫内膜疾病的患病率更高(=0.003)。术前CA125值以及不孕或未生育女性之间未发现差异(>0.05)。对于45岁及以上的卵巢子宫内膜异位症女性,以绝经后状态和卵巢子宫内膜瘤(≥8 cm)为特征的患者亚组发生EAOC的风险更高。对于该人群,尤其是那些并发子宫内膜疾病的人群,应考虑积极干预或加强随访。