摘要
目的:探讨卵巢子宫内膜样癌(EC)和卵巢透明细胞癌(CCC)的临床、超声、病理特征及与子宫内膜异位症的合并率.方法:对 2017 年 6 月—2022 年 5 月在我院就诊的卵巢CCC(n=63 例)和EC(n=53 例)患者的资料进行回顾性分析.收集并分析两组患者的临床特征(年龄、组织学、术前CA-125 水平、术前CEA水平、肿瘤大小、是否合并子宫内膜癌等)、超声及病理特征.结果:两组患者部位、最大径、术前CA-125 水平、术前CEA水平比较差异均无统计学意义(P>0.05),EC组患者年龄低于CCC组(P<0.05),EC组合并子宫内膜癌的比例高于CCC组(P<0.05).两组患者超声特征中病灶最长径、肿块性质、边界、形态、阻力指数(RI)等差异均无统计学意义(P>0.05).病灶最长径、肿块性质、边界、形态、RI等超声特征鉴别CCC和EC的AUC均低于 0.7.EC组免疫组化表现为ER、PR、CK7、EMA、Vim阳性,P63、53 及P16 阴性或灶性阳性,CK20、CK15、Napsin-A 阴性;CCC组免疫组化表现为CK7 和EMA阳性,ER、PR、P53、P16、CD125、Napsin-A阴性或灶性阳性,CK20、P63 和Vim阴性.CCC和EC组患者再阅片后子宫内膜异位症比例显著升高(P<0.05).结论:卵巢EC患者合并子宫内膜异位症、ER阳性率高于卵巢CCC患者,超声检查恶性特征明显,但缺乏鉴别CCC和EC的特异性表现,卵巢EC和CCC病理报告中存在子宫内膜异位症低估现象.
Abstract
Objective:To investigate the clinical,ultrasound,pathological features,and incidence of endometriosis in ovarian endometrioid carcinoma(EC)and ovarian clear cell carcinoma(CCC).Methods:The data of ovarian CCC(n=63)and EC(n=53)patients in our hospital from June 2017 to May 2022 were retrospectively analyzed.The clinical characteristics(age,histology,serum CA-125 levels,preoperative CEA levels,tumor size,presence or absence of endometrial cancer),ultrasound examination,and pathological features of two groups of patients were collected and analyzed.Results:There was no significant difference between the two groups in site,maximum diameter,preoperative CA-125 and CEA levels(P>0.05).The age of EC group was lower than that of CCC group(P<0.05),and the proportion of EC group with endometriosis was higher than that of CCC group(P<0.05).There was no significant difference in the longest diameter,nature,boundary,shape and resistive index(RI)of the lesion between the two groups(P>0.05).The AUC for distinguishing CCC and EC based on ultrasound features such as the longest diameter of the lesion,nature of the mass,boundary,morphology,and RI was all below 0.7.In EC group,ER,PR,CK7,EMA and Vim were positive,P63,53 and P16 were negative or focal positive,and CK20,CK15 and Napsin-A were negative.In CCC group,CK7 and EMA were positive,ER,PR,P53,P16,CD125,Napsin-A were negative or focal positive,CK20,P63 and Vim were negative.After rereading,the proportion of endometriosis in CCC and EC groups increased significantly(P<0.05).Conclusion:The incidence of ovarian EC combined with endometriosis and ER positive rate are higher than those of ovarian CCC patients.Malignant features are obvious under ultrasound,but there is a lack of specificity in distinguishing between CCC and EC,and there is an underestimation of endometriosis in the pathological reports of ovarian EC and CCC.
基金项目
2020年度西南医科大学-西南医科大学附属中医医院联合项目(西南医大科[2020]6号)
2020年度西南医科大学-西南医科大学附属中医医院联合项目(2020XYLH-043)
维普
万方数据