原发性卵巢癌肉瘤诊断与治疗5例并文献复习
Diagnosis and Treatment of Primary Ovarian Carcinosarcoma in Five Cases and Literature Review
DOI: 10.12677/acm.2025.153887, PDF,   
作者: 时钟岩*：青岛大学青岛医学院，山东 青岛；于风胜, 于 啸, 王文杰, 王言奎#：青岛大学附属医院妇科，山东 青岛
关键词: 卵巢癌肉瘤；手术；化疗；预后；Ovarian Carcinosarcoma； Surgery； Chemotherapy； Prognosis
摘要: 通过分析卵巢癌肉瘤的临床表现、体征、临床资料、诊疗过程及生存结局，结合国内外文献，总结最新诊疗方法，进而提升对该疾病的认识。本文回顾性分析青岛大学附属医院收治的5例卵巢癌肉瘤患者的临床表现以及诊断与治疗经验，并对相关文献进行回顾总结。所有患者均未出现特定症状，且糖类抗原125 (CA125)和人附睾蛋白4 (HE4)水平均升高。影像学检查显示4例患者为单侧卵巢肿瘤，1例患者累及双侧卵巢。增强CT扫描显示囊实性肿块，实性部分明显增强。5例患者均接受手术治疗，术后行紫杉醇和铂类化疗。3例患者没有复发或转移，1例患者复发后行维持化疗，1例患者死于复发和转移。
Abstract: By analyzing the clinical manifestations, signs, clinical data, diagnosis and treatment process, and survival outcomes of ovarian carcinosarcoma, combined with domestic and foreign literature, the latest diagnosis and treatment methods are summarized to enhance the understanding of this disease. This article retrospectively analyzes the clinical manifestations, diagnosis, and treatment experience of 5 patients with ovarian carcinosarcoma admitted to the Affiliated Hospital of Qingdao University, and reviews and summarizes related literature. All patients did not exhibit specific symptoms, and the levels of carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) were elevated. Imaging examinations showed that 4 patients had unilateral ovarian tumors, and 1 patient involved both ovaries. Enhanced CT scan shows a cystic solid mass with significant enhancement in the solid part. All 5 patients underwent surgical treatment, followed by paclitaxel and platinum-based chemotherapy. Three patients did not experience recurrence or metastasis, one patient underwent maintenance chemotherapy after recurrence, and one patient died from recurrence and metastasis.
文章引用：时钟岩, 于风胜, 于啸, 王文杰, 王言奎. 原发性卵巢癌肉瘤诊断与治疗5例并文献复习[J]. 临床医学进展, 2025, 15(3): 2513-2520. https://doi.org/10.12677/acm.2025.153887

参考文献

[1] Daniyal, M., Polani, A.S. and Canary, M. (2023) Ovarian Carcinosarcoma and Response to Immunotherapy. Cureus, 15, e37149. [Google Scholar] [CrossRef] [PubMed]
[2] Dasgupta, S., Bose, D., Bhattacharyya, N. and Biswas, P. (2015) Carcinosarcoma of Ovary with Its Various Immunohistochemical Expression: Report of a Rare Case. Journal of Cancer Research and Therapeutics, 11, Article 1022. [Google Scholar] [CrossRef] [PubMed]
[3] Rocha, J., Mota, R., Portugal, R., Paiva, V. and Costa, A. (2016) Carcinosarcoma of Ovary: Report of a Rare Case. European Journal of Obstetrics & Gynecology and Reproductive Biology, 206, e96. [Google Scholar] [CrossRef] 
[4] del Carmen, M.G., Birrer, M. and Schorge, J.O. (2012) Carcinosarcoma of the Ovary: A Review of the Literature. Gynecologic Oncology, 125, 271-277. [Google Scholar] [CrossRef] [PubMed]
[5] Boussios, S., Karathanasi, A., Zakynthinakis-Kyriakou, N., Tsiouris, A.K., Chatziantoniou, A.A., Kanellos, F.S., et al. (2019) Ovarian Carcinosarcoma: Current Developments and Future Perspectives. Critical Reviews in Oncology/Hematology, 134, 46-55. [Google Scholar] [CrossRef] [PubMed]
[6] Cantrell, L.A. and Van Le, L. (2009) Carcinosarcoma of the Ovary. Obstetrical & Gynecological Survey, 64, 673-680. [Google Scholar] [CrossRef] [PubMed]
[7] Arora, P., Rao, S., Khurana, N., Talwar, D. and Tanwar, R. (2011) Malignant Mixed Mullerian Tumor of Broad Ligament with Synchronous Ovarian and Endometrial Carcinoma: A Rare Association. Journal of Cancer Research and Therapeutics, 7, 88-91. [Google Scholar] [CrossRef] [PubMed]
[8] Berton-Rigaud, D., Devouassoux-Shisheboran, M., Ledermann, J.A., Leitao, M.M., Powell, M.A., Poveda, A., et al. (2014) Gynecologic Cancer Intergroup (GCIG) Consensus Review for Uterine and Ovarian Carcinosarcoma. International Journal of Gynecological Cancer, 24, S55-S60. [Google Scholar] [CrossRef] [PubMed]
[9] Xu, Q., Zhang, X.F. and Zou, Y. (2020) Primitive Ovarian Carcinosarcoma: A Clinical and Radiological Analysis of Five Cases. Journal of Ovarian Research, 13, Article No. 129. [Google Scholar] [CrossRef] [PubMed]
[10] Brown, E., Stewart, M., Rye, T., Al‐Nafussi, A., Williams, A.R.W., Bradburn, M., et al. (2004) Carcinosarcoma of the Ovary. Cancer, 100, 2148-2153. [Google Scholar] [CrossRef] [PubMed]
[11] Barnholtzsloan, J., Morris, R., Malone, J. and Munkarah, A. (2004) Survival of Women Diagnosed with Malignant, Mixed Mullerian Tumors of the Ovary (OMMMT). Gynecologic Oncology, 93, 506-512. [Google Scholar] [CrossRef] [PubMed]
[12] Selvi, K., Toi, P.C. and Badhe, B.A. (2014) A Rare Case of Primary Leiomyosarcoma of the Ovary in Association with Cellular Leiomyoma of the Broad Ligament and Uterus. Journal of Gynecologic Surgery, 30, 363-366. [Google Scholar] [CrossRef] 
[13] Rauh-Hain, J.A., Gonzalez, R., Bregar, A.J., Clemmer, J., Hernández-Blanquisett, A., Clark, R.M., et al. (2016) Patterns of Care, Predictors and Outcomes of Chemotherapy for Ovarian Carcinosarcoma: A National Cancer Database Analysis. Gynecologic Oncology, 142, 38-43. [Google Scholar] [CrossRef] [PubMed]
[14] Jain, V., Pundir, S., Sekhon, R., Mishra, A., Nayyar, N., Vishwakarma, G., et al. (2019) Carcinosarcoma of the Ovary: A Single-Institute Experience with Surgical Cytoreduction and Platinum-Based Chemotherapy. Journal of Gynecologic Surgery, 35, 224-231. [Google Scholar] [CrossRef] 
[15] Athavale, R., Thomakos, N., Godfrey, K., Kew, F., Cross, P., de Barros Lopes, A., et al. (2007) The Effect of Epithelial and Stromal Tumor Components on FIGO Stages III and IV Ovarian Carcinosarcomas Treated with Primary Surgery and Chemotherapy. International Journal of Gynecological Cancer, 17, 1025-1030. [Google Scholar] [CrossRef] [PubMed]
[16] Patnayak, R., Jena, A., Prakash, J., Sundaram, R., Vijaylaxmi, B. and Lakhmi, A.Y. (2015) Primary Carcinosarcoma of Ovary an Unusual Tumor Case Report with Review of Literature. Journal of Basic and Clinical Reproductive Sciences, 4, 39-42. [Google Scholar] [CrossRef] 
[17] Rauh-Hain, J.A., Birrer, M. and del Carmen, M.G. (2016) Carcinosarcoma of the Ovary, Fallopian Tube, and Peritoneum: Prognostic Factors and Treatment Modalities. Gynecologic Oncology, 142, 248-254. [Google Scholar] [CrossRef] [PubMed]
[18] Muntz, H.G., Jones, M.A., Goff, B.A., Fuller, A.F., Nikrui, N., Rice, L.W., et al. (1995) Malignant Mixed Müllerian Tumors of the Ovary. Experience with Surgical Cytoreduction and Combination Chemotherapy. Cancer, 76, 1209-1213. [Google Scholar] [CrossRef] 
[19] Sood, A.K., Sorosky, J.I., Gelder, M.S., Buller, R.E., Anderson, B., Wilkinson, E.J., et al. (1998) Primary Ovarian Sarcoma. Cancer, 82, 1731-1737. [Google Scholar] [CrossRef] 
[20] Wang, W., Li, N., Zhang, Y., Gao, Y., Sun, Y., Ge, L., et al. (2018) Prognostic Significance of Lymph Node Metastasis and Lymphadenectomy in Early-Stage Ovarian Carcinosarcoma. Cancer Management and Research, 10, 1959-1968. [Google Scholar] [CrossRef] [PubMed]
[21] Garg, G., Shah, J.P., Kumar, S., et al. (2010) Ovarian and Uterine Carcinosarcomas: A Comparative Analysis of Prognostic Variables and Survival Outcomes. International Journal of Gynecologic Cancer, 20, 888-894. [Google Scholar] [CrossRef] 
[22] Rauh-Hain, J.A., Growdon, W.B., Rodriguez, N., Goodman, A.K., Boruta, D.M., Schorge, J.O., et al. (2011) Carcinosarcoma of the Ovary: A Case-Control Study. Gynecologic Oncology, 121, 477-481. [Google Scholar] [CrossRef] [PubMed]
[23] George, E.M., Herzog, T.J., Neugut, A.I., Lu, Y., Burke, W.M., Lewin, S.N., et al. (2013) Carcinosarcoma of the Ovary: Natural History, Patterns of Treatment, and Outcome. Gynecologic Oncology, 131, 42-45. [Google Scholar] [CrossRef] [PubMed]
[24] Pushpagiri, N., Dinakaran, S., Chidambaram, A. and Pari, P. (2016) Carcinosarcoma of Ovary—A Rare Case Report and Literature Overview. International Journal of Advances in Medicine, 3, 440-442. [Google Scholar] [CrossRef] 
[25] Powell, M.A., Filiaci, V.L., Hensley, M.L., Huang, H.Q., Moore, K.N., Tewari, K.S., et al. (2022) Randomized Phase III Trial of Paclitaxel and Carboplatin versus Paclitaxel and Ifosfamide in Patients with Carcinosarcoma of the Uterus or Ovary: An NRG Oncology Trial. Journal of Clinical Oncology, 40, 968-977. [Google Scholar] [CrossRef] [PubMed]
[26] Brackmann, M., Stasenko, M., Uppal, S., Erba, J., Reynolds, R.K. and McLean, K. (2018) Comparison of First-Line Chemotherapy Regimens for Ovarian Carcinosarcoma: A Single Institution Case Series and Review of the Literature. BMC Cancer, 18, Article No. 172. [Google Scholar] [CrossRef] [PubMed]
[27] Mano, M.S., Rosa, D.D., Azambuja, E., Ismael, G., Braga, S., D’Hondt, V., et al. (2007) Current Management of Ovarian Carcinosarcoma. International Journal of Gynecological Cancer, 17, 316-324. [Google Scholar] [CrossRef] [PubMed]
[28] Romeo, C., Le Saux, O., Jacobs, M., Joly, F., Ferron, G., Favier, L., et al. (2022) Therapeutic Challenges in Patients with Gynecologic Carcinosarcomas: Analysis of a Multicenter National Cohort Study from the French Prospective TMRG Network. Cancers, 14, Article 354. [Google Scholar] [CrossRef] [PubMed]
[29] Zhu, J., Wen, H., Ju, X.Z., Bi, R., Zuo, W.J. and Wu, X.H. (2017) Clinical Significance of Programmed Death Ligand-1 and Intra-Tumoral CD8+ T Lymphocytes in Ovarian Carcinosarcoma. PLOS ONE, 12, e0170879. [Google Scholar] [CrossRef] [PubMed]
[30] Zhang, J.Q., Zhao, B.B., Wang, M.M. and Li, L. (2021) Case Report: Niraparib as Maintenance Therapy in a Patient with Ovarian Carcinosarcoma. Frontiers in Oncology, 11, Article 603591. [Google Scholar] [CrossRef] [PubMed]
[31] Wu, J.X., Cheng, J.H., Zhang, F.X., Luo, X.Y., Zhang, Z.M. and Chen, S. (2020) Estrogen Receptor Α Is Involved in the Regulation of ITGA8 Methylation in Estrogen Receptor-Positive Breast Cancer. Annals of Translational Medicine, 8, 993-993. [Google Scholar] [CrossRef] [PubMed]
[32] Ismail, A., Choi, S. and Boussios, S. (2023) Frontiers of Ovarian Carcinosarcoma. Current Treatment Options in Oncology, 24, 1667-1682. [Google Scholar] [CrossRef] [PubMed]

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