Advances for the Clinical Diagnosis and Treatment of Endometriosis-Associated Ovarian Cancer

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (06) : 828 -832. doi: 10.3877/cma.j.issn.1673-5250.2013.06.027 所属专题： 文献； 综述 子宫内膜异位症相关卵巢癌的临床诊治进展 - 1. 610041 成都四川大学华西第二医院妇产科 - 1. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province , China 子宫内膜异位症(EMs)是最常见的妇科疾病之一，于育龄期妇女中的发病率为10%～15%。流行病学研究表明，EMs增加了上皮性卵巢癌的发生风险，尤其是子宫内膜样癌和侵袭性透明细胞癌的发生风险。目前关于EMs相关卵巢癌(EAOC)的病因和发病机制的研究尚未阐明。研究认为，EAOC可能与肝细胞核因子(HNF)-1β和ARID1A等基因的突变及氧化应激等有关。EAOC在发现时多处于早期，临床表现无特异性。MRI诊断EAOC具有较高的特异性和灵敏度，但该病的最终确诊主要依靠组织病理学检查。在EAOC治疗方面，目前主要采取以手术治疗辅以术后化疗，而靶向治疗、早期预防治疗同样重要。EAOC一旦确诊应尽早手术，由于其具有易复发的特点，术后密切随访是必要的。EAOC的化疗目前多主张采用紫杉醇加铂类，但效果不理想。目前研究发现，EAOC较无EMs的卵巢癌(OC)有更好的预后。 Endometriosis (EMs) is one of the most common gynecological diseases, its incidence rate about 10%-15% of all pre-menopausal women. Epidemiological studies had shown that EMs increases the risk of development of ovarian cancer(OC),especially endometrioid and invasive clear cell carcinoma. The etiology and pathogenesis of endometriosis-associated ovarian cancer(EAOC) is not yet clear, which may associated with the hepatocyte nuclear factor (HNF)-1β or ARID1A gene mutations and oxidative stress, etc. EAOC mostly was diagnosed in the early stage which has non-specific clinical manifestations. EAOC, which confirmed diagnosis is histopathological examination, has high specificity and sensitivity in MRI. In the treatment, presently take performed surgery and supplemented by postoperative chemotherapy as the principal thing. It's targeted therapy and early prevention are equally important. Once EAOC is diagnosed, surgery should be performed as soon as possible. What's more, due to easily recurrence,close follow-up is necessary after the surgery. Currently in chemotherapy paclitaxel plus platinum-based was advocated,but the effect is not ideal. 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