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与子宫内膜异位症相关的卵巢癌有两种可能的实体:相关的还是偶然的?
Francesco Mezzapesa1, Giulia Dondi2, Camelia Alexandra Coada3
1IRCCS Azienda Ospedaliero-Universitaria di Bologna, Division of Oncologic Gynecology, Bologna, Italy; University of Bologna, Department of Medical and Surgical Sciences (DIMEC), Bologna, Italy.
概括
与子宫内膜异位症相关的卵巢癌呈现两种不同的临床形式. 与子宫内膜异位症相关的卵巢癌作为与子宫内膜异位症相关的卵巢癌和没有子宫内膜异位症的卵巢癌之间的过渡类别.
科学领域:
- 妇科瘤学 妇科瘤学
- 病理学 病理学 病理学
- 生殖医学 生殖医学
背景情况:
- 子宫内膜异位症是特定卵巢癌亚型的危险因素.
- 区分与子宫内膜异位症相关的卵巢癌和没有子宫内膜异位症的卵巢癌对于了解疾病进展和治疗至关重要.
研究的目的:
- 描述和区分两种类型的与子宫内膜异位症相关的卵巢癌:与子宫内膜异位症相关的和子宫内膜异位症相关的,与没有子宫内膜异位症的卵巢癌.
- 为了确定手术前的变量,以便准确的患者分类.
主要方法:
- 前性,观察性,单心研究 (2021年11月至2023年12月).
- 170名卵巢癌患者被分为三个组:与子宫内膜异位症相关的,子宫内膜异位症偶然的或没有子宫内膜异位症.
- 对临床,超声波,手术,病理学数据和无进展生存率的分析.
- 使用手术前变量开发后勤回归模型.
主要成果:
- 与子宫内膜异位症相关的卵巢癌 (两种类型) 在年轻时被诊断出来,更低的绝经后发病率.
- 与子宫内膜异位症相关的卵巢癌表现出明显的特征:怀孕较少,CA-19.9较高,单侧/多部位固体病变,早期阶段,疾病不那么广泛,和更高的完整细胞减少率.
- 基因型各异:透明细胞,子宫内膜状,与子宫内膜异位相关的中膜状;与子宫内膜异位相关的其他类型中,血清细胞占主导地位.
- 后勤回归模型准确地区分了与子宫内膜异位症相关的其他组 (AUC > 0.926).
- 两年无进展存活率在子宫内膜异位症偶然性 (91%) 中最高,其次是子宫内膜异位症相关性 (80%),在没有子宫内膜异位症的卵巢癌中最低 (59%).
结论:
- 与子宫内膜异位症相关的卵巢癌包括两个不同的临床实体.
- 与子宫内膜异位症相关的卵巢癌作为一个中间类别,将与子宫内膜异位症相关的卵巢癌和没有子宫内膜异位症的卵巢癌联系起来.
- 这些发现支持这些亚型的独特管理和研究策略.
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