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目的 探讨以转移灶症状为首发症状就诊的卵巢上皮性癌(EOC)的临床特点、治疗和预后。方法 自1986年1月-1997年12月我院收25例盆腔病灶隐匿、最初表现均为远处转移灶症状的EOC患者,回顾性分析其临床资料。结果 首发症状为锁骨上和腹股沟淋巴结转移者最多见,分别为6例和5例;2个以上部位转移者6例。16例(64%)术后盆腹腔残留灶直径≤1cm。20例Ⅳ期患者的中位生存时间为24个月;仅有有上淋巴结或胸膜转移者中位生存时间为30个月,明显高于其他部位转移患者的19个月(P=0.0264)。结论 以转移灶症状为首发症状就诊的EOC预后较好,特别是仅有锁骨上淋巴结或胸膜转移者,不应放弃积极的手术和化学治疗。 相似文献
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卵巢上皮性癌生存率及预后因素分析 总被引:4,自引:0,他引:4
目的 :研究影响卵巢上皮性癌 (EOC)生存率和预后的诸因素。方法 :回顾分析EOC 16 4例的临床病理及随访资料。结果 :患者 3、5、10年生存率分别为 6 3.0 %、4 4 .7%、4 0 .2 %。 5年生存率 :临床Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为 90 .0 %、72 .7%、35 .9%、15 .0 % ;G1、G2 、G3分别为 81.4 %、5 0 .5 %、2 5 .0 % ;宫内膜样癌为 6 2 .1% ,未分类腺癌、粘液性癌和浆液性癌分别为 2 4 .4 %、32 .7%、4 0 .5 % ;初次手术时有腹水为 39.9% ,无腹水为 6 8.3% ;初次手术后残留癌灶 >2cm为 7.4 % ,≤ 2cm为 35 .5 % ,无肉眼残留癌灶为 70 .8%。中、晚期初次手术后化疗疗程数≥ 6个、1~ 5个及未化疗者 5年生存率分别为 5 8.8%、2 3.6 %、0。结论 :肿瘤的组织类型、细胞分级、临床分期、初次手术时腹水、初次手术后残留癌灶大小是影响生存率和预后的重要因素 ,中晚期EOC初次手术后化疗疗程是否足够与生存率明显相关 相似文献
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杜雪 《国外医学:妇产科学分册》2007,34(5):333-335
卵巢上皮性癌脑转移是卵巢癌少见的并发症。脑转移发生率增高主要与目前正规、有效的化疗使肿瘤患者生存期延长有关。其诊断依据病史、症状和辅助检查,比较容易。治疗方法主要有外科手术、立体定向放疗、全脑放疗、化疗及其他治疗方法综合应用。对近年来卵巢上皮性癌脑转移的发生率、发病机制、诊断、治疗措施及预后情况综述如下。 相似文献
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Ⅰ期卵巢上皮性癌的预后因素 总被引:1,自引:0,他引:1
对我院1962年至1989年收治的67例Ⅰ期卵巢上皮性癌患者进行回顾性分析。按收治年代将其分为三组。结果:三组除采用的化学疗法(法疗)的方法不同外,其它治疗及患者的临床病理特点比较,差异无显著意义。60年代(第一组),70年代(第二组)。80年代(第三组)治疗的患者预后随时间逐步改善,其5年生存率分别为46%,82%和97%。第一组与第二组5年生存存率比较,差异有非常显著意义(P<0.001);第 相似文献
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卵巢上皮性癌脑转移是卵巢癌少见的并发症.脑转移发生率增高主要与目前正规、有效的化疗使肿瘤患者生存期延长有关.其诊断依据病史、症状和辅助检查,比较容易.治疗方法主要有外科手术、立体定向放疗、全脑放疗、化疗及其他治疗方法综合应用.对近年来卵巢上皮性癌脑转移的发生率、发病机制、诊断、治疗措施及预后情况综述如下. 相似文献
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卵巢上皮性癌脑转移10例临床分析 总被引:5,自引:0,他引:5
目的 探讨卵巢上皮性癌脑转移的发生率、诊断、治疗及预后等相关因素。方法 回顾性分析1996—2001年,收治的卵巢上皮性癌478例中发生脑转移10例患者的临床资料。结果 卵巢上皮性癌脑转移的发生率为2.1%;脑转移常见的首发症状为头痛、呕吐、肢体乏力;常见的转移部位为脑顶部及枕部。10例患者中,8例行颅脑放射治疗及全身化学药物治疗,其中7例完成了治疗,颅脑照射剂量,单发病灶为30—38Gy/4周,多发病灶为40—45Gy/5周。10例患者总体中位生存时间为6.3个月,其中7例完成治疗者为8.3个月,3例放弃治疗及末完成治疗者为1.4个月。结论 脑转移的诊断主要依据临床症状、体征及影像学检查;联合应用颅脑放射治疗及全身化学药物治疗,大部分患者的病情可获得明显缓解。 相似文献
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目的 探讨一种新的转移抑制基因--RKIP基因与卵巢癌转移的关系.方法 应用免疫组化、RT-PCR及蛋白印迹法对卵巢肿瘤的组织标本(卵巢癌组织22份,卵巢交界性肿瘤组织8份,卵巢良性肿瘤组织10份)及卵巢癌细胞系中RKIP基因的表达情况进行检测.将含正义和反义RKIP cDNA的表达载体导入卵巢癌细胞系SKOV3,蛋白印迹法榆测转染前后细胞中丝裂原激活的蛋白激酶/细胞外信号调节激酶的激酶(MEK)、细胞外信号调节激酶(ERK)活性的,变化.应用叫甲基偶氮唑蓝法、双层软琼脂集落形成实验、体外黏附实验、体外侵袭实验、流式细胞仪等观察RKIP基因对卵巢癌细胞生物学行为的影响.结果 (1)22份卵巢癌组织中RKIP的表达以阴性(6份,27%)、弱阳性(9份,41%)为主,而10份卵巢良性肿瘤和8份交界性肿瘤组织以强阳性(分别为4份、2份)、阳性(分别为4份、5份)为主.(2)RKlP基因转染后,含正义cDNA的ssRKIP细胞的磷酸化MEK和磷酸化ERK蛋白表达水平下调,ssRKIP#1和ssRKIP#4细胞磷酸化MEK蛋白的相埘表达含量分别为0.35和0.34,两者磷酸化ERK蛋白的相对表达含最分别为0.48和0.46.(3)ssRKIP细胞的增殖能力明显低于未转染细胞(P<0.01).(4)锚定非依赖性生长能力:ssRKIP#1、ssRKIP#4细胞的集落形成数(83.7±5.7、106.0±9.2)较其对照空载体pcDNA3.1(+)转染细胞(158.3±14.6)明显减少,分别比较,差异均有统计学意义(P<0.01).(5)体外黏附能力:ssRKIP#1、ssRKIP#4细胞的黏附率[分别为(68.3±0.8)%、(64.1±0.9)%]明显低于未转染细胞[(100.0±1.1)%],分别比较,差异均有统计学意义(P<0.01).(6)体外侵袭能力:ssRKIP#1、ssRKIP#4细胞的穿膜细胞数[分别为(24±5)、(25±4)个]明显低于未转染细胞[(68±5)个],分别比较,差异均有统计学意义(P<0.01).(7)ssRKIP细胞呈G1期细胞比例增加和G2+S期细胞比例下降.结论 RKIP基因不仅对卵巢癌细胞的侵袭、转移有抑制作用,且对其生长也有抑制作用. 相似文献
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卵巢转移癌63例临床分析 总被引:2,自引:0,他引:2
卵巢转移癌63例临床分析姜阿英,王纯雁,李联昆指导谢克(辽宁省肿瘤医院)非生殖器来源的卵巢转移癌是卵巢恶性肿瘤中较常见的癌瘤,约占卵巢恶性肿瘤的3.28~20%[1-5],国内报告最高达23.1%[4]。1980年5月~1990年5月我院共收治卵巢癌... 相似文献
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卵巢交界性上皮性肿瘤的临床病理分析 总被引:6,自引:1,他引:5
目的 探讨影响卵巢交界性上皮性肿瘤预后的临床及病理因素。方法 回顾性分析我院 1973年 1月~ 2 0 0 0年 12月收治的 3 4例卵巢交界性上皮性肿瘤及 3 0例Ⅰ期卵巢上皮性癌 (卵巢癌 )患者的临床病理资料 ,并按 1999年WHO的组织学标准核对诊断。结果 64例患者中 ,符合卵巢交界性上皮性肿瘤诊断者 3 7例 ,其中 6例微浸润的卵巢交界性上皮性肿瘤曾被误诊为Ⅰ期卵巢癌 ,1例卵巢交界性上皮性肿瘤为非浸润性腹膜种植。卵巢癌组织学类型以黏液性和浆液性为主 ,95 %为国际妇产科联盟 (FIGO)临床分期的Ⅰ期。患者均行手术治疗 ,其中 11例行保守手术者复发率为9% ;2 6例肿瘤细胞减灭术后给予环磷酰胺 +阿霉素 +顺铂 (CAP)方案为主的化学药物治疗 (化疗 )。已随访 5年、10年患者的生存率均达 10 0 %。经多因素相关分析显示 ,组织学类型和是否化疗是影响预后的因素 (P <0 0 1)。结论 卵巢交界性上皮性肿瘤患者以手术治疗为主 ,应适当辅以化疗 相似文献
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BACKGROUND: Skin metastases from ovarian carcinoma are rarely reported. Most cases present as cutaneous nodules, generally as periumbilical Sister Joseph's nodules. An uncommon presentation of cutaneous metastases from ovarian epithelial carcinoma is the inflammatory pattern, which mimics herpetiform lesions to the skin. CASE: A 48-year-old patient with refractory ovarian carcinoma, complicated by groin lymph node metastatic disease developed edema, in the form of "Peau d'orange," over the lower abdominal skin, the upper aspects of the lower extremities, and the gluteal skin. Large areas of multiple erythematous vesicular appearance that resembled herpes zoster lesions were noted. Biopsy of the skin lesions revealed ovarian skin metastases. CONCLUSIONS: The diagnosis of ovarian skin metastases is uncommon. It mimics inflammatory viral infection as herpes zoster lesions. Supportive care is needed due to painful presentation. 相似文献
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复发性卵巢上皮性癌再次手术的临床评价 总被引:11,自引:0,他引:11
目的 探讨复发性卵巢上皮性癌 (卵巢癌 )再次手术的指征及临床意义。方法 复发性卵巢癌再次手术的患者 5 5例 ,术前及术后均进行化学药物治疗 (化疗 )或放射治疗 (放疗 ) ,再次手术共 6 8例次。根据再次手术前不同病灶的性质分为 4组 ,即单个复发灶组、多个复发灶组、因肠梗阻手术组及姑息性手术组。并根据再次手术前对化疗的敏感程度分为 3组 ,即≤ 6个月复发组、>6个月复发组及肿瘤进展组。观察每组再次手术中进行满意的肿瘤细胞减灭术的例数、手术并发症的例数及手术治疗的有效率、生存时间、疾病缓解时间。结果 再次手术前通过检查认为是单个复发灶者 ,6 1%在再次手术中发现为多个复发灶 ;单个复发灶组中获得较满意的肿瘤细胞减灭术的为 6 7% ,术前认为是单个复发灶者而在再次手术中确诊为多个复发灶者中 ,获得较满意的肿瘤细胞减灭术的为6 4 % ;多个复发灶组获得满意的肿瘤细胞减灭术的为 4 3%。再次手术治疗的有效率 ,以单个复发灶组最高 ;手术后疾病缓解时间及生存时间 ,也以单个复发灶组最长 ;单个复发灶组手术并发症少于多个复发灶组。获得满意的肿瘤细胞减灭术 ,停止化疗 >6个月复发组为 73% ;≤ 6个月复发组为80 % ;肿瘤进展组为 5 0 %。结论 单个复发灶组、停止化疗 >6个月复发组再次手 相似文献
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M. Marinaccio V. Pinto S. Geusa G. Lanzilotti L. Loiudice 《Archives of gynecology and obstetrics》1997,261(1):45-49
A rare case of involvement of the Central Nervous System characterized by brain and subsequent cerebellar metastases without
abdomino-pelvic spread is reported. The patient was treated by craniotomy plus external radiation to the brain. Subsequently,
Carboplatin-based chemotherapy was started when paraaortic lymph-nodes involvement has been detected. Follow-up is uneventful
after clinical complete remission.
Received: 17 February 1997 / Accepted: 2 June 1997 相似文献
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Chiang YC Qiu JT Chang CL Wang PH Ho CM Lin WC Huang YF Lin H Lu CH Chou CY 《Gynecologic oncology》2012,125(1):37-41
Objective
To evaluate the characteristics and outcome of patients with brain metastases from epithelial ovarian carcinoma.Methods
The clinical and pathologic characteristics, treatment and outcome of patients with brain metastases from epithelial ovarian carcinoma were analyzed from eight medical centers in Taiwan under the TGOG (Taiwanese Gynecologic Oncology Group).Results
A total of 64 patients were recruited in this study. The incidence of brain metastases from epithelial ovarian carcinoma seemed to be increasing in recent years. The median survival from the diagnosis of brain metastases was 8 months (range: 0-72). Prior cancer relapse before the diagnosis of brain metastases, number of brain metastases and multimodal treatment were related to the duration of survival.Conclusions
The prognosis for patients with brain metastases from epithelial ovarian carcinoma is generally poor. However, clinicians should keep alert to the neurological complaints of ovarian cancer patients and the patients might benefit from aggressive multimodal treatments. 相似文献17.
Brain metastases from epithelial ovarian cancer 总被引:2,自引:0,他引:2
Brain metastasis from epithelial ovarian cancer is uncommon. We studied the presentation, treatment, and prognosis of brain metastasis in a single institution. A retrospective review of clinical details kept in the computer database of gynecologic oncology services in a tertiary institution between 1993 and 2003 was done. A Medline search for English publications on brain metastasis from epithelial ovarian cancer was performed from 1966 to 2003. The study period included 605 patients, and 4 (0.66%) patients developed brain metastases. The patients were usually well, until they presented with hemiparesis. The median primary treatment to brain metastasis interval was 16.5 months. Three out of four cases had multiple brain metastases, and all had small-volume extracranial tumor relapses. Serum CA125 measurement was not reliable in the screening for brain metastasis. The median survival after brain metastasis was 19.5 months. Single brain metastasis can be treated with surgery. Our experience supports the prevalent published opinion that all other cases should be considered for combined radiotherapy and surgery or radiotherapy and chemotherapy. Surveillance of tumor recurrence with serum CA125 monitoring does not predict brain metastasis, which carries a poor prognosis. The best mode of management of these patients is yet to be determined. Large study with multicenter participation to establish the standard treatment is urgently needed. 相似文献
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Wright JD Powell MA Mutch DG Rader JS Gibb RK Huettner PC Herzog TJ 《Gynecologic oncology》2004,92(3):851-855
OBJECTIVE: The aim of the study was to identify clinical features, define prognostic factors and optimize treatment in patients with colorectal cancer with synchronous ovarian metastases at the time of initial diagnosis. METHODS: A retrospective analysis of patients treated by the gynecologic oncology service at Barnes Jewish Hospital between 1990 and 2001 was performed. Twenty-eight patients with colorectal carcinomas with synchronous ovarian metastases at the time of diagnosis were identified. Clinical and pathological characteristics were evaluated, and survival was analyzed by the method of Kaplan and Meier. RESULTS: Abdominal pain was the most common symptom at presentation. Only 14% of the patients presented with gastrointestinal bleeding. Fifty-four percent of patients who underwent barium enema had intrinsic colonic lesions, while 40% of patients who had endoscopies performed had their colonic tumors identified. Preoperatively colon cancer was considered in the differential diagnosis of 71% of the patients. At exploration, the ovarian metastases were significantly larger than the primary colon tumors. Overall, 68% of patients had intraperitoneal nodal metastasis and 86% had transmural extension of their tumors. The only pathological variable associated with survival was tumor grade. The median disease-free survival was 10.3 months while the median overall survival was 18.4 months. CONCLUSION: Most patients with colon cancer with synchronous ovarian metastases present with vague symptoms. At exploration, locally advanced tumors and other distant metastases such as in the liver are common. Surgical management should include extirpation of the primary tumor and any bulky ovarian metastases. Cytoreduction may be considered in highly selected patients. 相似文献
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卵巢上皮性癌组织中DNA甲基转移酶亚型mRNA的表达及其意义 总被引:2,自引:0,他引:2
目的 探讨DNA甲基转移酶(DNMT)亚型mRNA在卵巢上皮性癌组织中的表达及其临床意义。方法 采用半定量RT-PCR技术测定55例卵巢上皮性癌组织(其中原发性40例、复发性15例)及20例正常卵巢组织中DNMT亚型1、3A及3BmRNA的表达水平,并对其相关临床病理指标进行分析。结果 正常卵巢、原发性及复发性卵巢上皮性癌组织中,DNMT1 mRNA的表达水平分别为1.15、3.11、2.85,3者之间比较,差异有统计学意义(P〈0.05);DNMT3A mRNA的表达水平分别为1.32、0.71、1.24,3者之间比较,差异无统计学意义(P〉0.05);DNMT3B mRNA表达水平分别为0.25、0.60、2.12,复发性卵巢上皮性癌组织显著高于其他两者(P〈0.01)。原发性卵巢上皮性癌组织中DNMT1 mRNA表达水平,中低分化、手术病理分期为Ⅲ~Ⅳ期、淋巴结转移阳性者明显高于高分化、Ⅰ~Ⅱ期及淋巴结转移阴性者(分别为4.92和1.38,6.02和2.13,8.25和2.40;P均〈0.05)。原发性卵巢上皮性癌组织中,浆液性癌和透明细胞癌组织中DNMT1、3A、3BmRNA表达水平(分别为5.64、1.00、0.78)均明显高于其他病理类型(分别为1.76、0.44、0.23;P均〈0.05)。COX回归分析发现,卵巢上皮性癌组织中DNMT3B mRNA表达水平可能是影响患者生存期的惟一因素。结论 原发性及复发性卵巢上皮性癌组织中,DNMT1、3BmRNA高表达与其疾病进展及预后有关。 相似文献
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T.-J. KIM S. SONG C.K. KIM† W.Y. KIM C.H. CHOI J.-H. LEE J.-W. LEE D.-S. BAE & B.-G. KIM 《International journal of gynecological cancer》2007,17(6):1252-1257
Brain metastasis from epithelial ovarian carcinoma (EOC) is managed by a multimodal treatment approach. Thus, to determine the prognostic factors associated with this situation is important for management decisions regarding the type of treatment and aggressiveness of treatment. From 1995 to 2005, 13 patients with brain metastases resulting from EOC underwent treatment at Samsung Medical Center. We retrospectively reviewed the medical records to determine prognostic factors and to evaluate treatment outcome. The median age at diagnosis for primary ovarian carcinoma and brain metastasis was 52 and 55 years, respectively. Median interval to brain metastases was 28 months after the diagnosis of EOC. At the time of analysis, nine patients had died of disease. The median survival from brain relapse was 7 months. A Karnofsky performance status of 70 or higher, primary control, solitary brain lesions, recursive partitioning analysis (RPA) class, and treatment modality including gamma-knife radiosurgery (GKRS) were related to survival on univariate analyses. Multivariate analysis showed that treatment modality including GKRS was a more important prognostic factor than RPA class (P = 0.04). This small series demonstrated that GKRS can be a valuable modality for the management of brain metastasis in patients with EOC. Therefore, a better outcome can be achieved by choosing GKRS in their treatments in selected patients. 相似文献