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比较和分析 SCEO 和 ECOM 的临床病理特征。

Comparison and analysis of the clinicopathological features of SCEO and ECOM.

机构信息

Department of Gynecology, obstetrics and gynecology hospital, Fudan university, Shanghai, 200,090, China.

出版信息

J Ovarian Res. 2019 Jan 30;12(1):10. doi: 10.1186/s13048-019-0485-5.

Abstract

OBJECTIVE

The aim of our study was to evaluate and compare the differences in the clinicopathological variables and overall survival (OS) of synchronous primary cancers of the endometrium and ovary (SCEO) and endometrial cancer with ovarian metastasis (ECOM). In addition, we aimed to determine the characteristics of and effective treatments for patients with SCEO to avoid misdiagnosis and overtreatment.

MATERIALS AND METHODS

A review of medical records from January 2009 to January 2017 revealed 111 patients with coexisting ovarian and endometrial carcinoma diagnosed at the Obstetrics and Gynecology Hospital of Fudan University. Clinicopathological variables were analysed using the Chi square test and Student's t test. The survival rate was estimated using the Kaplan-Meier method, and statistical significance was analysed using the logarithmic rank test (univariate analysis).

RESULTS

There were 51 cases of SCEO and 60 cases of ECOM. The mean age at diagnosis was 53.96 years and 55.41 years, respectively. There were no differences in age, menopausal status, BMI, CA125 level or complaints between the two groups. The 5-year survival rates were 58.8 and 36.7%, respectively (P < 0.001). Significant differences were found in the endometrial tumour classification, ovarian cancer stage, and lymph node and omentum metastasis between SCEO and ECOM.

CONCLUSIONS

The differences found between SCEO and ECOM are of great clinical significance. Our results reveal useful prognostic and clinicopathological features. More aggressive therapies should be administered to both SCEO and ECOM patients, especially elderly patients and those with menopause, endometrial tumours, advanced omentum metastasis, and lymph node dissection.

摘要

目的

本研究旨在评估和比较同时性子宫内膜和卵巢原发性癌(SCEO)与卵巢转移子宫内膜癌(ECOM)的临床病理变量和总生存期(OS)差异。此外,我们旨在确定 SCEO 患者的特征和有效治疗方法,以避免误诊和过度治疗。

材料与方法

回顾性分析 2009 年 1 月至 2017 年 1 月在复旦大学妇产科医院诊断为同时性卵巢和子宫内膜癌的 111 例患者的病历。采用卡方检验和 Student's t 检验分析临床病理变量。采用 Kaplan-Meier 法估计生存率,对数秩检验(单因素分析)分析统计学意义。

结果

SCEO 组 51 例,ECOM 组 60 例。诊断时的平均年龄分别为 53.96 岁和 55.41 岁。两组间年龄、绝经状态、BMI、CA125 水平或症状无差异。5 年生存率分别为 58.8%和 36.7%(P<0.001)。SCEO 和 ECOM 组在子宫内膜肿瘤分类、卵巢癌分期以及淋巴结和大网膜转移方面存在显著差异。

结论

SCEO 和 ECOM 之间的差异具有重要的临床意义。我们的结果揭示了有用的预后和临床病理特征。SCEO 和 ECOM 患者,尤其是老年患者和绝经后患者、子宫内膜肿瘤、进展性大网膜转移和淋巴结清扫患者,应接受更积极的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8542/6352368/85cc3e782a4b/13048_2019_485_Fig1_HTML.jpg

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