妇科疾病影像学（十四）：卵巢透明细胞癌的临床和超声特征。

Imaging in gynecological disease (14): clinical and ultrasound characteristics of ovarian clear cell carcinoma.

机构信息

Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy.

Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Ultrasound Obstet Gynecol. 2018 Dec;52(6):792-800. doi: 10.1002/uog.19171.

DOI:10.1002/uog.19171

PMID:29978567

Abstract

OBJECTIVE

To describe the clinical and ultrasound characteristics of ovarian pure clear cell carcinoma.

METHODS

This was a retrospective study involving data from 11 ultrasound centers. From the International Ovarian Tumor Analysis (IOTA) database, 105 patients who had undergone preoperative ultrasound examination by an experienced ultrasound examiner between 1999 and 2016 were identified with a histologically confirmed pure clear cell carcinoma of the ovary. An additional 47 patients diagnosed with pure clear cell carcinoma between 1999 and 2016 and with available complete preoperative ultrasound reports were identified retrospectively from the databases of the departments of gynecological oncology in the participating centers. The ultrasound images of all tumors were described using IOTA terminology. Clinical and ultrasound characteristics were analyzed for the whole group, and separately, for patients with and those without histologically confirmed endometriosis, and for patients with evidence of tumor developing from endometriosis.

RESULTS

Median age of the 152 patients was 53.5 (range, 28-92) years and 92/152 (60.5%) tumors were FIGO Stage I. Most tumors (128/152, 84.2%) were unilateral. On ultrasound examination, all tumors contained solid components and 36/152 (23.7%) were completely solid masses. The median largest diameter of the lesion was 117 (range, 25-310) mm. Papillary projections were present in 58/152 (38.2%) masses and, in most of these (51/56, 91.1%), vascularized papillary projections were seen. Information regarding the presence, site and type of pelvic endometriosis at histology was available for 130/152 patients. Endometriosis was noted in 54 (41.5%) of these. In 24/130 (18.6%) patients, the tumor was judged to have developed from endometriosis. Patients with, compared to those without, evidence of tumor developing from endometriosis were younger (median 47.5 vs 55.0 years, respectively), and ground-glass echogenicity of cyst fluid was more common in pure clear cell cancers developing from endometriosis (10/20 vs 13/79 (50.0% vs 16.5%), respectively).

CONCLUSIONS

Ovarian pure clear cell carcinoma is usually diagnosed at an early stage and typically appears as a large unilateral mass with solid components. Patients with clear cell carcinoma developing from endometriosis are younger than other patients with clear cell carcinoma, and clear cell cancers developing from endometriosis more often manifest ground-glass echogenicity of cyst fluid. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

摘要

目的

描述卵巢单纯透明细胞癌的临床和超声特征。

方法

这是一项回顾性研究，涉及 11 个超声中心的数据。从国际卵巢肿瘤分析（IOTA）数据库中，确定了 1999 年至 2016 年间由经验丰富的超声检查人员进行术前超声检查且组织学证实为卵巢单纯透明细胞癌的 105 例患者。另外，从参与中心妇科肿瘤学系的数据库中回顾性地确定了 1999 年至 2016 年间诊断为单纯透明细胞癌且有完整术前超声报告的 47 例患者。所有肿瘤的超声图像均采用 IOTA 术语进行描述。对所有患者进行临床和超声特征分析，并分别对有和无组织学证实子宫内膜异位症的患者以及有子宫内膜异位症来源肿瘤证据的患者进行分析。

结果

152 例患者的中位年龄为 53.5（范围，28-92）岁，92/152（60.5%）肿瘤为 FIGO Ⅰ期。大多数肿瘤（128/152，84.2%）为单侧。超声检查显示，所有肿瘤均含有实性成分，36/152（23.7%）为完全实性肿块。病变的最大直径中位数为 117（范围，25-310）mm。58/152（38.2%）肿块存在乳头状突起，其中大多数（51/56，91.1%）可见血管化的乳头状突起。130/152 例患者中有组织学上存在、部位和类型的盆腔子宫内膜异位症的信息。这些患者中有 54 例（41.5%）存在子宫内膜异位症。在 130 例患者中有 24 例（18.6%）被认为肿瘤来源于子宫内膜异位症。与无肿瘤来源于子宫内膜异位症的患者相比，有肿瘤来源于子宫内膜异位症的患者更年轻（分别为 47.5 岁和 55.0 岁），并且肿瘤来源于子宫内膜异位症的透明细胞癌中囊液呈磨玻璃样回声更为常见（分别为 10/20 例和 13/79 例（50.0%和 16.5%））。