He Zheng-Xing, Shi Hong-Hui, Fan Qing-Bo, Zhu Lan, Leng Jin-Hua, Sun Da-Wei, Li Zhan-Fei, Shen Keng, Wang Shu, Lang Jing-He
Department of Gynecology and Obstetrics, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, People's Republic of China.
J Ovarian Res. 2017 Jul 17;10(1):45. doi: 10.1186/s13048-017-0343-2.
To explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis (OEM) aged 45 years and above in China.
This study reviewed the medical records of 1038 women in total who were aged 45 years and above, surgical-pathologically diagnosed with ovarian endometriosis, and were treated at Peking Union Medical College Hospital between December 1996 and December 2016. Histology evaluation was used to determine whether the ovarian endometriosis specimen was with (n = 30) or without (n = 1008) ovarian cancer.
2.9% (30/1038) of women with the surgical-pathological diagnosis of ovarian endometriosis were found to have EAOC. Those patients with EAOC were prone to be in the postmenopausal status at the time of the diagnosis (OR 5.50, 95%CI 2.54-11.90, P < .001) and larger size of tumor (≥8 cm, OR 7.19, 95% CI 3.34-15.50, P < .001), and higher prevalence of coexisting with endometrial disorders (OR 4.11, 95%CI 1.73-9.73, P = .003). This study showed that patients of an older age when diagnosed with OEM, were at a higher risk of developing EAOC, respectively measuring of 1.7% (13/751) at 45-49 years, 5.6% (12/215) at 50-54 years, and 10.0%(5/50) at 55-59 years (P < 0.001).
This study showed that for women aged 45 years and above who were diagnosed with OEM, the independent risk factors of EAOC were menopausal status, tumor size of 8 cm or greater in diameter, and coexisting endometrial disorders. Therefore, intensive follow-ups or active interventions should be considered for them.
探讨中国45岁及以上卵巢子宫内膜异位症（OEM）女性发生子宫内膜异位症相关卵巢癌（EAOC）的危险因素。
本研究回顾了1996年12月至2016年12月期间在北京协和医院接受治疗的1038名45岁及以上经手术病理诊断为卵巢子宫内膜异位症女性的病历。采用组织学评估来确定卵巢子宫内膜异位症标本是否伴有（n = 30）或不伴有（n = 1008）卵巢癌。
经手术病理诊断为卵巢子宫内膜异位症的女性中，2.9%（30/1038）被发现患有EAOC。那些患有EAOC的患者在诊断时更容易处于绝经后状态（OR 5.50，95%CI 2.54 - 11.90，P <.001）、肿瘤体积较大（≥8 cm，OR 7.19，95%CI 3.34 - 15.50，P <.001），以及合并子宫内膜疾病的患病率更高（OR 4.11，95%CI 1.73 - 9.73，P =.003）。本研究表明，诊断为OEM时年龄较大的患者发生EAOC的风险更高，45 - 49岁时为1.7%（13/751），50 - 54岁时为5.6%（12/215），55 - 59岁时为10.0%（5/50）（P < 0.001）。
本研究表明，对于45岁及以上诊断为OEM的女性，EAOC的独立危险因素是绝经状态、直径8 cm或更大的肿瘤大小以及合并子宫内膜疾病。因此，应考虑对她们进行密切随访或积极干预。
