| Objective:The clinical features and prognosis of endometriosis associated ovarian cancer and epithelial ovarian carcinoma were compared by using systematic reviews method,which provided the basis diagnosis and treatment for clinic.Research Methodology:By conducting a systematical search to find the related studies about endometriosis associated ovarian cancer and epithelial ovarian cancer,through the databases such as Pub Med?Medline?Web of science ?CNKI?Wan fang Database?VIP Database etc.The language is limited to Chinese and English only.Searching for cohort and case-control studies until August,2017.Independent review,evaluation and data extraction were performed by two researchers based on inclusion criteria and exclusion criteria.According to a meta-analysis requirement,the data were analyzed by using RevMan5.3 software.Results:This study is based on 20 literatures in the meta-analysis,including 14 Chinese studies and 6 studies in English.Application of Newcastle-Ottawa Scale(NOS scale)to evaluate the quality of the 20 studies.(1)The age of patients with endometriosis associated ovarian cancer was relatively younger compared to epithelial ovarian cancer,and the difference was statistically significant(OR =-3.99,95% CI [-4.39,-3.58],P <0.00001);? Serum CA125 concentration,endometriosis associated ovarian cancer may be between 35-200 U / ml,and epithelial ovarian cancer more than 200 U / ml,and the difference was statistically significant(OR = 5.97,95% CI [2.97,12.01],P <0.00001),but the sensitivity analysis showed that the conclusion unreliable.(3)Tumor diameter between the two groups makes no sense.(4)The difference in menopausal status between the two group was no statistically difference.(5)Endometriosis associated ovarian cancer showed an earlier FIGO staging compared to epithelial ovarian cancer,and the difference was statistically significant(OR = 3.81,95% CI [2.65,5.49],P <0.00001);(6)Endometriosis associated ovarian cancer showed a better tumor grade compared to epithelial ovarian cancer,and the difference was statistically significant(OR=2.43,95%CI[1.40,4.20],P=0.002);(7)Endometriosis associated ovarian cancer more prone to vaginal bleeding symptom(OR=2.69,95%CI[1.01,7.17],P=0.05).(8)There was no difference in the incidence of irregular abdominal pain between the two groups,but the sensitivity analysis showed that the conclusion was more sensitive and poor reliability;(9)If the patient had the conscious of pelvic mass,there are no difference,but the sensitivity analysis showed that the conclusion was more sensitive and poor reliability;(10)Endometriosis associated ovarian cancer was more prone to menstrual changes(OR = 2.55,95% CI [1.37,4.73],P = 0.03);(11)The probability of ascites in EAOC was lower than that in OC,there was a significant difference between the two groups(OR = 2.55,95% CI [1.37,4.73],P = 0.03).Sensitivity analysis showed that the conclusion was poor in reliability;(12)Endometriosis associated ovarian cancer has a better five-year survival rate,and the difference was statistically significant(OR = 3.81,95% CI [2.65,5.49],P <0.00001).Conclusion:1.Compared to epithelial ovarian cancer,endometriosis associated ovarian cancer are young,with early FIGO stage,a better tumor grade;In clinical symptom,are more prone to have menstruation changes and irregular vaginal bleeding situation.2.Among serum CA125 concentrations,EAOC maybe between 35-200 U/ml,while OC is often more than 200 U/ml.With the conscious of pelvic mass between the two groups are no difference.3.The chance of ascites of endometriosis associated ovarian cancer may be lower than epithelial ovarian cancer.4.Tumor diameter,irregular abdominal pain and menopausal status of patients can not be used as prompted the two differences of the two,the strength of this argument is small,poor reliable,still need a large RCT of high quality data to confirm the conclusion. |
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