Clinicopathological Features Of Ovarian Endometriosis-Associated Ovarian Clear Cell Carcinoma:a Report Of22Cases

Objective: To explore the clinicopathological features and prognosis of patientswith endometriosis-associated ovarian clear cell carcinoma.Methods:60cases of ovarian clear cell carcinoma, which were treated withsurgery and diagnosed by pathology in Dalian Maternity hospital from January2002toNovember2011,were analyzed retrospectively. Among the60cases,7cases were foundto originate from ovarian endometriosis (Group A),15cases were found to haveco-existing ovarian endometriosis (Group B),and the remaining38cases had no ovarianendometriosis at all (Group C).To analysis comparatively their common symptoms,clinicopathological features and prognosis.Results:1Sixty cases were identified and their clinicopathological data were retrieved.22cases（36.4%）were found to have coexisting endometriosis. The frequency of malignanttransformation of ovarian endometriosis in this case series was11.7%.2Clinicopathological features(1) The mean (standard deviation) age in groups A, B, and C were（41.4±12.5）、（48.0±6.2）、（51.1±7.7）years, respectively, with patients in group A beingsignificantly younger than that of group C（P=0.005）and there being no significantdifference between group B and group A or group C(P>0.05). The difference inmenopause factor among the three groups did not reach statistical significant（P>0.05）.There were more nulliparity in group A than that in group C, and significantdifference was observed between two groups（P=0.021）,there was no significantdifference between group B and group A or group C(P>0.05). (2)The mainly symptoms of patients in three groups were pelvic mass, abdominaldistention, irregular vaginal bleeding, dysmenorrhea and frequent urination, but therewas no significant difference among three groups（P>0.05）.(3) There was no mixed epithelial carcinoma in group A, one case (6.7%) in groupB,7cases (18.4%) in group C. But there was no significant difference among threegroups（P>0.05）。(4)Through ultrasound examination, Group C showed more cystic and solid mixedmass than other groups (2=6.866，P=0.032),but the difference between group A andgroup B had no statistical significance（P>0.05）, the difference was not statisticallysignificant between group A and group C（P>0.05）,the difference between group B andgroup C had statistical significance（2=4.414，P=0.036）.The tumor size and CA125levels had no statistical significance among three groups(P>0.05).(5)Most of the patients in groups A and B were diagnosed at stage Ⅰ, andsignificantly higher than that in group C（2=6.101，P=0.047）, and the differencebetween group A and group B had no statistical significance（P>0.05）, the differencewas statistically significant between group A and group C（P=0.040）, no statisticalsignificance was obtained between group B and group C（P>0.05）.There was nostatistical significance among the patients which were diagnosed at stage Ⅱ, Ⅲ andⅣ（P>0.05）.3The five-year survival rate of the three groups were50.0%,71.4%,36.8%,respectively, no significant difference was observed（P>0.05）.Conclusions: Most of the ovarian endometriosis-associated ovarian clear cellcarcinoma patients were found to be younger, nonporous, and at an early stage,havingshowed more cystic mass and lower CA125with better prognosis. Young patients withovarian endometriosis still need to wary of the malignant transformation.