中国癌症杂志 ›› 2017, Vol. 27 ›› Issue (4): 281-286.doi: 10.19401/j.cnki.1007-3639.2017.04.007

• 论著 • 上一篇    下一篇

卵巢淋巴瘤和以淋巴结转移为主的卵巢癌临床特征比较

高菲菲 1,郭 垒2,薛 恺3,盛伟琪4,王 葳5,李目杰6,郑 重7,李子庭7   

  1. 1. 上海市第八人民医院妇产科,上海 200235 ;
    2. 濉溪县中医院妇产科,安徽 淮北 235000 ;
    3. 复旦大学附属肿瘤医院肿瘤内科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    4. 复旦大学附属肿瘤医院病理科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    5. 复旦大学附属肿瘤医院影像科,复旦大学上海医学院肿瘤学系,上海 200032 ;
    6. 沈阳药科大学中药学院,辽宁 沈阳 110016 ;
    7. 复旦大学附属肿瘤医院妇瘤科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2017-04-30 发布日期:2017-05-05
  • 通信作者: 郑 重 E-mail: alizheng@126.com
  • 基金资助:
    上海市卫计委青年项目(20154Y0066);国家自然科学基金青年项目(81400161,81101649)。

Comparison of the clinical characteristics of ovarian lymphoma and ovarian cancer with bulk lymph node involvement

GAO Feifei1, GUO Lei2, XUE Kai3, SHENG Weiqi4, WANG Wei5, LI Mujie6, ZHENG Zhong7, LI Ziting7   

  1. 1. Department of Obstetrics and Gynaecology, Shanghai Eighth People’s Hospital, Shanghai 200235, China; 2. Department of Obstetrics and Gynaecology, Suixi County Hospital of Traditional Chinese Medicine, Huaibei 235000, Anhui Province, China; 3. Department of Medical Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 4. Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 5. Department of Diagnostic Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; 6. School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China; 7. Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2017-04-30 Online:2017-05-05
  • Contact: ZHENG Zhong E-mail: alizheng@126.com

摘要: 背景与目的:卵巢淋巴瘤(ovarian lymphoma,OL)和以淋巴结转移为主的卵巢癌 (ovarian cancer with bulk lymph node invasion,OC-BLN)常被相互误诊,该研究通过比较两者间临床特点,帮助鉴别。方法:回顾2008年11月—2016年1月复旦大学附属肿瘤医院和上海市第八人民医院共14例OL和14例OC-BLN的临床特征、影像学资料及实验室检查数据进行对比分析。结果:两组在年龄、症状、伴发腹水、发热、体重减轻和输尿管梗阻比率间差异无统计学意义,OL组卵巢肿块直径更大[(13.04±5.94) cm vs (7.78±6.38) cm,P=0.033]、实性肿瘤比率更高(85.71% vs 28.57%,P=0.006)。卵巢淋巴瘤患者血清LDH/CA125比值为7.66±8.03,高于卵巢癌组的0.31±0.27(P=0.009)。以LDH/CA125值作为卵巢淋巴瘤诊断指标,曲线下面积(area under the curve,AUC)可达0.952,如选取1作为临界值,灵敏度和特异度分别为91.7%和100%。结论:OL与OC-BLN存在的临床特征易混淆,但通过卵巢肿瘤表现和血清LDH/CA125值的比较可帮助鉴别诊断,从而更好地指导下一步的临床治疗。

关键词: 卵巢淋巴瘤, 卵巢癌, 临床特征, CA125, 乳酸脱氢酶

Abstract: Background and purpose: Ovarian lymphoma (OL) is usually misdiagnosed as ovarian cancer with bulk lymph node invasion (OC-BLN), and vice versa. Therefore, to distinguish these two types of disease, we compared their clinical characteristics in this study. Methods: This study retrospectively reviewed 14 OL and 14 OCBLN patients from Fudan University Shanghai Cancer Center and Shanghai Eighth People’s Hospital. The clinical characteristics, image and laboratory examination data were compared. Results: There was no significant difference in age, symptom, fever, weight loss and volume of ascitic fluid between the two groups. Comparing with OC-BLN, OL patients have larger tumor in ovaries [(13.04±5.94) cm vs (7.78±6.38) cm, P=0.033], and higher percentage of solid ovarian tumor (85.71% vs 28.5%, P=0.006). Lactate dehydrogenase(LDH)/CA125 was higher in OL (7.66±8.03) than OC-BLN (0.31±0.27, P=0.009). Using LDH/CA125 to diagnose OL, area under the curve (AUC) was 0.952. When the threshold value was set at 1, the sensitivity and specificity was 91.7% and 100%, respectively. Conclusion: OL and OC-BLN are easily to be misdiagnosed. OL has larger and more solid tumor than OC-BLN. LDH/CA125 can help to distinguish these two diseases and guide clinical decision making.

Key words: Ovarian lymphoma, Ovarian cancer, Clinic characteristics, CA125, Lactate dehydrogenase