Objective : To study the clinical pathological characteristics and high risk factors for borderline ovarian tumor ( BOT) and stage Ⅰ epithelial ovarian cancer ( EOC). Methods: A total of 91 patients with BOT and 52 patients with stage Ⅰ EOC who were diagnosed and treated in the Department of Gynecology , Peking University People ' s Hospital from November 2002 to May 2010 were recruited in this study. The patients' clinical characteristics were reviewed respectively and compared between the two groups. Results: The women in BOT group were significantly younger than those in EOC group(41. 16 ± 14.95 vs. 50.90 ± 14. 37,P ＜0. 01). Compared with women with BOT, women with EOC were more likely to be post-menopausal(42.3％ vs. 23. 1％ ,P =0.016) and more with family history of malignant tumors (26. 9％ vs. 13. 2％ ,P = 0. 04 ) . There were no significant differences in the size of tumors and the serum level of tumor markers. But the size of solid portion of the tumor of EOC was significantly larger than that of BOT( P ＜0. 01 ) . The extent of the increase of CP2 among the patients with EOC was higher than that among the patients with BOT( 256. 99 vs. 116. 59 , P = 0. 028) . There was a statistically significant difference between the two groups in tumors ' histopathological type ( P ＜ 0. 01 ) . The serous and mucous tumors were more common in EOC group (90. 1％ , 82/91). In contrary, endometrioid, clear cells and mixed epithelial cancers were more common in EOC group than serous and mucous cancers (44.2％ , 23/52). Conclusion: Although the clinical presentation of patients with stage Ⅰ EOC was similar to that of those with BOT, there were significant differences in the patients' age, post-menopausal or not, family history of malignant tumors, size of solid portion of tumors, extent of the increase of the tumor biomarker, especially of CP2 and tumors histopathological type. These clinicopathological characteristics might be helpful for us to make different diagnosis.%目的:比较卵巢交界性肿瘤及1期上皮性卵巢癌的临床病理特征,探讨鉴别于交界性肿瘤的早期上皮性卵巢癌的高危因素.方法:回顾性分析2002年11月至2010年5月于北京大学人民医院妇科诊治的143例卵巢交界性肿瘤(91例,borderline ovarian tumor,BOT组)和Ⅰ期上皮性卵巢癌患者(52例,epithelial ovarian carcinoma,EOC组),比较两组患者的临床病理特征.结果:BOT组患者发病年龄显著低于Ⅰ期卵巢癌患者[(41.16±14.95)岁vs.(50.90±14.37)岁,P<0.01],Ⅰ期卵巢癌患者中绝经患者占42.3%(22/52),有恶性肿瘤家族史患者占26.9%(14/52),均显著高于BOT组患者的23.1%(21/91,P=0.016)和13.2%(12/91,P=0.04).术前阴道彩色超声检查提示两组间肿物大小差异无统计学意义,但卵巢癌组患者肿物实性部分明显大于BOT组(P<0.01).两组间血清学肿瘤标记物(CA125,CA199,CP2,CEA)阳性率差异无统计学意义,但在CP2升高的患者中,Ⅰ期卵巢癌患者CP2值升高幅度显著高于BOT组(256.99 kU/L vs.116.59 kU/L,P=0.028).两组间肿物组织病理类型有显著不同,交界性肿瘤中以浆液性和黏液性肿瘤为主(90.1%,82/91),而Ⅰ期卵巢癌患者中浆液性和黏液性肿瘤仅占44.2%(23/52),但其他病理类型(如子宫内膜样癌、透明细胞癌和混合性上皮癌)比例明显增高(P<0.01).结论:早期上皮性卵巢癌与卵巢交界性肿瘤虽临床表现相似,但早期卵巢癌患者的发病年龄、绝经与否、恶性肿瘤家族史、超声检查提示的卵巢肿物实性部分大小、血清学肿瘤标记物的升高幅度(特别是CP2的升高程度)以及组织病理类型均有别于交界性肿瘤,这些临床病理特征可能有助于临床医师在术前对两种疾病进行鉴别诊断.
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