Thromboembolic complications in patients with clear cell carcinoma of the ovary
Thromboembolic complications in patients with clear cell carcinoma of the ovary
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DOI：
10.1016/j.ygyno.2006.08.026
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发表时间：
2007-02-01
影响因子：
4.7
通讯作者：
Hacker, Neville F.
中科院分区：
文献类型：
--
作者：
Matsuura, Yusuke;Robertson, Greg;Hacker, Neville F.
Objective.本研究旨在明确卵巢透明细胞癌（CCC）患者深静脉血栓（DVT）和肺栓塞（PE）的发生率，并探讨此类患者的预后因素。在1987年1月至2003年12月期间，641名患有原发性浸润性上皮性卵巢癌的妇女在澳大利亚悉尼的皇家妇女医院接受治疗。从数据库中识别出66例（10.3%）CCC患者，并将其数据与132例非透明细胞上皮性卵巢癌患者的匹配对照组进行比较。27.3%的CCC患者发生血栓栓塞事件（DVT或PE），而其他上皮性卵巢癌患者为6.8%。分别在13.6%和3.8%的患者中检测到PE。CCC患者在手术前或复发时常观察到DVT。在年龄和分期相匹配的患者的多变量分析中，DVT的发生或子宫内膜异位症的存在是透明细胞组织学的重要预测因素。在透明细胞组中，没有确定DVT的特定风险因素。单因素分析显示，直径≥ 50 mm的转移瘤、腹水≥ 1000 ml、FIGO分期、DVT发生率是CCC的不良预后因素，多因素考克斯回归分析显示，只有FIGO分期和DVT发生率仍有意义。与其他上皮性卵巢癌患者相比，CCC患者的静脉血栓栓塞事件发生率显著较高。(c)2006年爱思唯尔公司All rights reserved.
Objective. The purpose of this study was to define the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients with clear cell carcinoma (CCC) of the ovary and to investigate the prognostic factors in such patients.Methods. Between January 1987 and December 2003, 641 women with primary invasive epithelial ovarian cancer underwent treatment at the Royal Hospital for Women in Sydney, Australia. Sixty-six patients (10.3%) with CCC were identified from the data bank, and their data were compared with a matched-control group of 132 patients with non-clear cell epithelial ovarian carcinoma.Results. A thromboembolic event (DVT or PE) was noted in 27.3% of patients with CCC, compared to 6.8% of patients with other epithelial ovarian cancers. PE was detected in 13.6% and 3.8% of patients, respectively. In patients with CCC, DVT was frequently observed before operation or at the time of recurrence. In a multivariate analysis of patients matched for age and stage, the occurrence of a DVT or the presence of endometriosis was significant predictors of clear cell histology. Within the clear cell group, no particular risk factor for DVT could be identified. Metastases of 50 turn or greater in diameter, ascites of 1000 ml or more, advanced FIGO stage, and the occurrence of DVT were poor prognostic factors for CCC in univariate analysis, but in a multivariate Cox regression analysis, only FIGO stage and occurrence of DVT remained significant.Conclusion. The incidence of venous thromboembolic events was found to be significantly higher in patients with CCC when compared to patients with other epithelial ovarian cancers. (c) 2006 Elsevier Inc. All rights reserved.