Kikkawa F, Ishikawa H, Tamakoshi K, Nawa A, Suganuma N, Tomoda Y
Department of Obstetrics and Gynecology, Nagoya University School of Medicine, Japan.
Obstet Gynecol. 1997 Jun;89(6):1017-22. doi: 10.1016/s0029-7844(97)00117-8.
There have been few studies concerning the clinical pathology of squamous cell carcinoma arising from ovarian mature cystic teratoma. Thus, the objective of this study is to determine clinicopathologic factors affecting survival in this rare tumor.
From September 1979 to June 1996, 37 patients with squamous cell carcinoma arising from ovarian mature cystic teratoma were treated by the Tokai Ovarian Tumor Study Group. A retrospective clinicopathologic and survival analysis of these patients was performed. The mode of infiltration was classified into expansive, moderately diffused, and diffused patterns.
Although the 5-year survival rate was 94.7% and 80.0% for stage I and II patients, respectively, 12 of 13 patients with stage III died within 20 months (P = .0001). A significant difference was also observed between the survival of the groups with and without residual tumor at surgery (P = .0001). Pathologic features, grade, mode of infiltration, and vascular involvement were significant factors by univariate analysis. Multivariate analysis showed significant differences in survival related to grade (P = .0154) and mode of infiltration (P = .0053). The preoperative squamous cell carcinoma antigen level was significantly higher in the patients with squamous cell carcinoma arising from mature cystic teratoma than in patients with mature cystic teratoma (P < .0001).
This study suggests that pathologic factors, grade, and mode of infiltration can provide valuable information for predicting the survival of patients with squamous cell carcinoma arising from mature cystic teratoma. In addition, squamous cell carcinoma antigen may be a useful marker to detect this disease preoperatively.
关于卵巢成熟囊性畸胎瘤来源的鳞状细胞癌的临床病理学研究较少。因此，本研究的目的是确定影响这种罕见肿瘤患者生存的临床病理因素。
1979年9月至1996年6月，东海卵巢肿瘤研究组对37例卵巢成熟囊性畸胎瘤来源的鳞状细胞癌患者进行了治疗。对这些患者进行了回顾性临床病理和生存分析。浸润方式分为膨胀性、中度弥漫性和弥漫性。
虽然I期和II期患者的5年生存率分别为94.7%和80.0%，但13例III期患者中有12例在20个月内死亡（P = .0001）。手术时有无残留肿瘤的两组患者生存率也有显著差异（P = .0001）。单因素分析显示病理特征、分级、浸润方式和血管受累是显著因素。多因素分析显示与分级（P = .0154）和浸润方式（P = .0053）相关的生存率有显著差异。成熟囊性畸胎瘤来源的鳞状细胞癌患者术前鳞状细胞癌抗原水平显著高于成熟囊性畸胎瘤患者（P < .0001）。
本研究表明，病理因素、分级和浸润方式可为预测成熟囊性畸胎瘤来源的鳞状细胞癌患者的生存提供有价值的信息。此外，鳞状细胞癌抗原可能是术前检测该疾病的有用标志物。
