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目的:探讨原发性卵巢黏液性癌的临床特点,寻求恰当的治疗策略。方法:回顾分析24例卵巢黏液性癌和108例非黏液性癌患者的年龄、手术病理分期、残留病灶、化疗反应率,比较生存情况,分析影响预后的因素。结果:黏液性癌患者FIGO分期早(P=0.001)、肿瘤分级低(P=0.000)。两组患者的年龄没有差异,Ⅲ～Ⅳ期患者的手术满意率无差异(P=0.453)。黏液性癌组与非黏液性癌组初治时对紫杉醇+卡铂的化疗反应率无差异(63.2%vs 85.2%,P=0.212),黏液性癌组的耐药病例似乎与肿瘤分期、手术满意度无关,而且复发后耐药率明显升高至60%。黏液性癌组和非黏液性癌组患者的总体中位无进展生存期(PFS)(22个月vs 17个月,P=0.393)和中位总生存期(OS)(22个月vs 37.5个月,P=0.670)无差异。Ⅰ～Ⅱ期黏液性癌与非黏液性癌两组患者中位PFS(37.5个月vs 44个月,P=0.304)和OS(49个月vs 45个月,P=0.621)亦无差异。满意肿瘤细胞减灭术后的Ⅲ～Ⅳ期患者,黏液性癌组中位PFS比非黏液性癌组短(12个月vs27个月,P=0.003),中位OS也缩短(18个月vs 45个月,P=0.044);不满意肿瘤细胞减灭术后的Ⅲ～Ⅳ期患者两组中位PFS(7.5个月vs 16个月,P=0.533)和中位OS(18个月vs 33个月,P=0.192)无统计学差异。Cox多因素回归分析结果提示,影响患者无进展生存期的因素包括肿瘤病理类型、FIGO分期和手术满意度;而影响总生存期的因素只有手术满意度。结论:卵巢黏液性癌是上皮癌的一个独立类型,晚期黏液性癌患者比非黏液性癌预后差,化疗耐药可能是预后差的原因,需要筛选有效的化疗方案。
Objective: To investigate the clinical features of primary ovarian mucinous carcinoma and seek appropriate treatment strategies. Methods: Retrospective analysis of 24 cases of ovarian mucinous carcinoma and 108 cases of non-mucinous carcinoma of the age, surgical pathology staging, residual lesions, chemotherapy response rates, survival, analysis of prognostic factors. Results: Patients with mucinous carcinoma had higher FIGO stage (P = 0.001) and lower tumor grade (P = 0.000). There was no difference in age between the two groups, and there was no difference in the operative satisfaction between stage III and IV (P = 0.453). There was no difference in response rates to chemotherapy with paclitaxel and carboplatin between the mucinous and non-mucinous cancers at initial treatment (63.2% vs 85.2%, P = 0.212). The resistant cases of mucinous carcinoma appeared to be associated with tumor stage, surgery Satisfaction has nothing to do, and the relapse rate after drug resistance increased significantly to 60%. The overall median progression-free survival (PFS) was significantly higher in patients with mucinous carcinoma and non-mucinous cancers (22 months vs 17 months, P = 0.393) and median overall survival (OS 22 months vs 37.5 Months, P = 0.670) no difference. Median PFS (37.5 months vs 44 months, P = 0.304) and OS (49 months vs. 45 months, P = 0.621) were also indistinguishable between patients with stage I-II myxosarcoma and non-mucinous cancers. Patients with stage III-IV tumors who were satisfied with cytoreductive surgery had a lower median PFS than non-mucinous cancers (12 months vs 27 months, P = 0.003) and a median OS shortened (18 months vs 45 months, P = 0.044); median PFS (7.5 months vs 16 months, P = 0.533) and median OS (18 months) in patients who were not satisfied with cytoreductive surgery in stage III-IV vs 33 months, P = 0.192) There was no significant difference. Cox multivariate regression analysis showed that the factors that influence the progression-free survival of patients include tumor pathology type, FIGO staging and surgical satisfaction; while the factors affecting the overall survival were only surgical satisfaction. Conclusion: Ovarian mucinous carcinoma is an independent type of epithelial carcinoma. The prognosis of advanced mucinous carcinoma is worse than that of non-mucinous carcinoma. Chemoresistance may be the reason of poor prognosis, and the effective chemotherapy should be screened.