| BackgroundFndometrial cancer is one of the common malignant tumors of the female reprc iuctive system in China,and the incidence rate is increasing year by year.Uterine sere as carcinoma and endometrial clear cell carcinoma are rare pathological types of en ometrial cancer,with low incidence,high degree of malignancy,rapid disease progression.they are easy to infiltrate the deep myometrium of the uterus and occur(?)stant metastasis,leading to poor prognosis.At present,their etiology,clinical characteristics,pathological features,treatment and prognosis have not yet been mature.domestic and foreign experts have not reached a final consensus on their diagnosis and treatment.Because it is relatively rare,there is less literature at home and abroad to report them.Especially in China,the only research reports are mostly clinical analysis of small samples and lack of comparative studies.Therefore,this study is to investigate and compare the clinical characteristics,pathological features,follow-up and prognosis of patients with primary uterine serous carcinoma and endometrial clear cell carcinoma,in order to find their respective characteristics and the differences between the two,so as to better guide clinical diagnosis and treatment,and deepen the clinician’s awareness.ObjectiveThe objective of this study is to explore the clinical characteristics,pathological features,follow-up and prognosis of patients with uterine serous carcinoma and endometrial clear cell carcinoma and the differences between the two.MethodsThe clinical data of 97 patients with uterine serous cancer or endometrial clear cell cancer admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to October 2018 were retrospectively analyzed.Among them,61 cases were in the serous carcinoma group and 36 cases were in the clear cell carcinoma group.In this study,the clinical characteristics,pathological features,follow-up and prognosis of patients of the two groups were explored,and the relevant indicators of patients of the two groups were compared.Results(1)The proportion of overweight patients in the serous carcinoma group(59.02%)was higher than that in the clear cell carcinoma group(36.11%).There was a statistical difference in the proportion of overweight patients(BMI≥24 kg/m2 between the two groups(P=0.029).(2)The positive percentage of ascites cytology in the serous carcinoma group(39.34%)was higher than that in the clear cell carcinoma group(8.33%).There was a statistical difference in the positive percentage of ascites cytology between the two groups(P=0.001).(3)During the follow-up period,the recurrence rate in the serous carcinoma group was 39.34%(24/61),mainly with distant metastasis(58.33%),and the median recurrence time was 12.00 months.The recurrence rate in the clear cell carcinoma group was 36.11%(13/36),mainly with distant metastasis(69.23%),and the median recurrence time was 15.00 months.There was no statistical difference in postoperative recurrence rate between the two groups(P>0.05).(4)The 3-year progression-free survival rate was 67.1%in the serous carcinoma group and 63.1%in the clear cell carcinoma group,with no statistical difference between the two groups(P>0.05).The 3-year overall survival rate was 81.8%in the serous cancer group and 84.6%in the clear cell cancer group,with no statistical difference between the two groups(P>0.05).(5)Multivariate analysis found that elevated CA125 values,late pathological stages(stages Ⅲ to Ⅳ),and no received adjuvant treatment after surgery were independent risk factors for disease recurrence for the patients in the serous carcinoma group.menopause years≥10 and positive ascites cytology were independent death factor for survival for the patients in the serous carcinoma group.(6)Multivariate analysis found that elevated CA125 values was an independent risk factor for the recurrence and death factor for survival for the patients in the clear cell carcinoma group.Conclusion(1)Compared with patients with endometrial clear cell carcinoma,patients with uterine serous carcinoma are more li kely to be overweight(BMI≥24 kg/m2),and cancer cells are more likely to be seen in ascites or peritoneal lavage fluid.(2)There is no significant difference in prognosis between patients with uterine serous carcinoma and those with endometrial clear cell carcinoma.(3)Elevated preoperative CA125 value,late pathological stages,no received adjuvant treatment after surgery,menopausal years≥10,and positive ascites cytology are independent prognostic factors for the patients with uterine serous carcinoma.(4)Elevated preoperative CA125 value is an independent prognostic factor for patients with endometrial clear cell carcinoma. |
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