卵巢透明细胞癌20例临床分析并文献复习

Clinical Analysis of 20 Cases of Ovarian Clear Cell Carcinoma and Literature Review

摘要: 目的：通过对20例卵巢透明细胞癌(ovarian clear cell carcinoma, OCCC)患者进行回顾性总结，结合文献，探讨卵巢透明细胞癌的临床特点，与子宫内膜异位症的关系及治疗、预后情况。方法：对西北妇女儿童医院妇科近6年(2015-1至2021-7)收治的20例OCCC患者进行回顾性总结，全部的OCCC患者均进行了手术治疗，术后经病理明确诊断为卵巢透明细胞癌。收集、整理患者的临床病历资料，对患者各项指标进行整理分析，并电话随访患者生存情况，查阅2010年至2021年国内外相关文献，进行整理分析。结果：所分析的20例OCCC患者中，I期患者15例，占75%。II期患者2例，占10%；III期患者3例，占15%。OCCC患者发病年龄在34~70岁之间，平均发病年龄(48.10 ± 10.51)岁，未绝经患者15例，占75％，绝经患者5例，占25%。有消化系统症状就诊的8人，占40%，检查提示盆腔包块的10人，占50%，包块直径大于10 cm者11人，占55%；肿瘤单侧居多占85％，双侧均有肿瘤的占15%。均进行了全面分期手术，经过全面分期手术及化疗后，I期患者预后好，II期、III期患者预后较差，较少发生铂类耐药。结论：I期OCCC患者经过全面分期手术后预后好，生存情况较好，较少发生铂类耐药；在本组病例中，I期患者占75%，患者均未复发，且生存状态好，而II期、III期患者数据过少，难以计算总生存率。未来需要更多大规模前瞻性临床研究以明确早期OCCC的生物学特性、临床特点及预后相关因素。

Abstract: Aim: To investigate the clinical features of ovarian clear cell carcinoma (OCCC), its relationship with endometriosis and its treatment and prognosis by retrospectively summarizing 20 patients with OCCC and combining them with the literature. Methods: A retrospective summary of 20 patients with OCCC admitted to the Department of Gynecology of Northwest Women’s and Children’s Hospital in the past 6 years (2015-1 to 2021-7) was conducted. All patients with OCCC underwent surgery and were clearly diagnosed as ovarian clear cell carcinoma by pathology after surgery. The patients’ clinical records were collected and collated, the patients’ indicators were collated and analysed, the patients’ survival was followed up by telephone, and relevant domestic and international literature from 2010 to 2021 was reviewed and collated for analysis. Results: Of the 20 OCCC patients ana-lysed, 15 (75%) were stage I patients, 2 (10%) were stage II patients, and 3 (15%) were stage III patients. The age of onset of OCCC patients ranged from 34 to 70 years, with an average age of onset of 48.10 ± 10.51 years. There were 15 premenopausal patients, accounting for 75%, and 5 post-menopausal patients, accounting for 25%. There were 8 patients (40%) with digestive system symptoms, 10 patients (50%) with pelvic mass, and 11 patients (55%) with mass diameter greater than 10 cm. Unilateral tumors accounted for 85%, and bilateral tumors accounted for 15%. All pa-tients underwent comprehensive staging surgery. After comprehensive staging surgery and chem-otherapy, the prognosis of stage I patients was good, and the prognosis of stage II and III patients was poor, and platinum resistance was less common. Conclusion: Patients with stage I OCCC have a good prognosis after comprehensive staging surgery, with a good survival rate and less plati-num-based resistance. In this group of cases, 75% of the patients with stage I had no recurrence and had a good survival status. However, the data of stage II and III patients were too few to calcu-late the overall survival rate. In the future, more large-scale prospective clinical studies are needed to clarify the biological characteristics, clinical characteristics and prognostic factors of early OCCC.