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卵巢透明细胞癌的临床特点耐药特征和预后因素分析
其他题名Clinical features and drug resistance characteristics of ovarian clear cell adenocarcinoma and analysis of its prognostic factors
张春妤; 郭红燕; 李华; 温宏武; 梁旭东; 乔杰
关键词卵巢肿瘤 腺癌 预后 透明细胞 抗药性 Ovarian Neoplasms 肿瘤 Adenocarcinoma Prognosis Clear Cell Drug Resistance Neoplasm
刊名中华肿瘤杂志
2012
DOI10.3760/cma.j.issn.0253-3766.2012.09.010
34期:9页:688-691
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 探讨卵巢透明细胞癌的临床特点和耐药特征,并分析影响预后的相关因索.方法 收集47例卵巢透明细胞癌患者的临床和随访资料,分析其临床特点、耐药特征和预后影响因素.以同期收治的53例卵巢浆液性腺癌患者作为对照.结果 卵巢透明细胞癌和卵巢浆液性腺癌患者的发病年龄分别为(49.09±11.80)岁和(55.51±1.38)岁,其中血CA125升高者分别占53.3%(24/45)和98.0% (50/51),合并子宫内膜异位症者分别占46.8%(22/47)和7.5%(4/53),早期(Ⅰ、Ⅱ期)患者所占的比例分别为80.9% (38/47)和11.3% (6/53),差异均有统计学意义(均P<0.05).卵巢透明细胞癌和卵巢浆液性腺癌患者的耐药率分别为26.1% (12/46)和24.0%(12/50),差异无统计学意义(P=0.814);但晚期卵巢透明细胞癌患者的耐药率(87.5%)明显高于卵巢浆液性腺癌(25.0%,P=0.003).卵巢透明细胞癌(OR=21.774,95% CI为2.438 ~194.431)以及分期晚(OR=58.329,95% CI为5.750 ~591.703)是与卵巢上皮性癌耐药密切相关的独立危险因素.晚期卵巢透明细胞癌与卵巢浆液性腺癌患者的中位生存时间(OS)分别为11和29个月,差异有统计学意义(P<0.001).病理类型为卵巢透明细胞癌、肿瘤晚期、手术不满意、化疗<6个疗程以及化疗耐药是与卵巢上皮性癌患者OS密切相关的独立危险因素(均P<0.05).结论 与卵巢浆液性腺癌相比,卵巢透明细胞癌患者的发病年龄早,多合并子宫内膜异位症,早期患者所占的比例较高;但卵巢透明细胞癌易发生耐药,在晚期患者中更明显,预后更差. Objective To investigate the clinical features and factors involved in the drug resistance and prognosis of ovarian clear cell adenocarcinoma (OCCA).Methods Forty-seven OCCA patients and 53 ovarian serous cyst adenocarcinoma (OSCA) patients were included in this study.Their clinical characteristics,drug resistance,and prognostic factors were analyzed.Results The onset age of OCCA was (49.09 + 11.80) years old,and that of OSCA was (55.51 + 1.38) year old.There were 53.3% (24/45)of OCCA and 98.0% (50/51) of OSCA patients who had elevated CA125 levels.There were 46.8% (22/47)of OCCA patients and 7.5% (4/53) of OSCA patients who suffered from endometriosis (EMS).The percentage of early stage (stage Ⅰ and stage Ⅱ) OCCA was 80.9% (38/47),and that of OSCA was 11.3% (6/53).A statistically significant difference was observed on all these aspects (P < 0.05).The percentage of drug resistant OCCA was 26.1% (12/46),and that of OSCA was 24.0% (12/50),with a non-significant difference (P =0.814).Among the patients with advanced stage disease,the percentage of drug resistance was 87.5% (7/8) for OCCA,while that of OSCA was 25.0% (11/44),showing a statistically significant difference (P =0.003).Multiple logistic regression analysis revealed that OCCA (OR=21.774,95%CI:2.438 to 194.431) and advanced stage (OR =58.329,95%CI:5.750 to 591.703)were independent risk factors of drug resistance in ovarian epithelial cancers.For the advanced stage patients,the median overall survival time of OCCA and OSCA were 11 and 29 months,respectively,with a statistically significant difference (P =0.000).Cox survival analysis showed that OCCA,advanced stage,suboptimal surgery,fewer than 6 cycles of chemotherapy and drug resistance were all risk factors of OS in ovarian cancer patients (P <0.05).Conclusions The age of onset in OCCA patients is younger than that of OSCA patients.The proportion of combination with endometriosis (EMS) is higher,and more early stage disease is observed in OCCA patients.The percentage of drug resistant in OCCA is higher,especially in advanced stage patients.The prognosis of advanced stage OCCA patients is poorer than that of OSCA patients in advanced stage.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/69838
专题北京大学第三临床医学院_妇产科
作者单位1.100191,北京大学第三医院妇产科
2.北京大学第一医院妇产科
3.北京大学人民医院妇产科
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张春妤,郭红燕,李华,等. 卵巢透明细胞癌的临床特点耐药特征和预后因素分析[J]. 中华肿瘤杂志,2012,34(9):688-691.
APA 张春妤,郭红燕,李华,温宏武,梁旭东,&乔杰.(2012).卵巢透明细胞癌的临床特点耐药特征和预后因素分析.中华肿瘤杂志,34(9),688-691.
MLA 张春妤,et al."卵巢透明细胞癌的临床特点耐药特征和预后因素分析".中华肿瘤杂志 34.9(2012):688-691.
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