Abstract:

Objective To discuss the clinical characteristics of the patients with ovarian clear cell carcinoma （OCCC） and ovarian endometriosis （OMA）， and to clarify the features of OCCC onset. Methods A retrospective analysis was conducted on the clinical data of 80 patients with post-operative pathological diagnosis of OCCC and 80 OMA patients diagnosed by post-operative pathology， who received surgical treatment from March 2011 to May 2021. The analysis included general characteristics， clinical manifestations， laboratory indices， and imaging examination indexes. The age， body mass index （BMI）， clinical symptoms such as abdominal pain， vaginal bleeding， and other symptoms （bloating， menstrual disorders， constipation， and abnormal vaginal discharge）， preoperative serum carbohydrate antigen 125 （CA125） levels， and ultrasound characteristics of ovarian cysts， such as cyst size， presence of pelvic effusion， and complexity， were compared between the patients in two groups. Multivariate Logistic regression analysis was used to identify the risk factors for OCCC， and the receiver operating characteristic （ROC） curve was drawn， and the area under the curve （AUC） was calculated. Results Compared with OMA group， the age of the patients in OCCC group was significantly increased （P<0.05）， the serum CA125 level was significantly increased （P<0.05）， the diameter of ovarian cyst was significantly increased （P<0.05）， and the percentage of the patients with pelvic effusion， other symptoms， and complex cysts was significantly increased （P<0.05）. The multivariate Logistic regression analysis results showed that age≥40 years （OR=56.856， 95%CI： 5.611-576.082， P=0.001）， complex ovarian cysts （OR=4.427， 95%CI： 1.025-19.114， P=0.046）， concomitant pelvic effusion （OR=8.760， 95%CI： 1.574-48.760， P=0.013）， and size of ovarian cysts （OR=1.782， 95%CI： 1.329-2.390， P<0.01） were the risk factors for OCCC. When the cut-off value of the ovarian cyst size was 7.35 cm， the sum of sensitivity （83.75%） and specificity （80.00%） was the highest， and the AUC was 0.883， indicating certain predictive value for identifying OCCC. Conclusion The patients aged≥40 years with cysts≥7.35 cm in diameter， especially those with complex cysts accompanied by pelvic effusion， have a higher risk of malignancy to OCCC， and active intervention is recommended.

Key words: Ovarian clear cell carcinoma, Ovarian endometriosis, Clinical characteristic, Risk factor, Complex cyst