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Comparison of Pure and Mixed-Type Clear Cell Carcinoma of the Ovary: A Clinicopathological Analysis of 341 Chinese Patients
  1. Shuang Ye, MD*,
  2. Yan You, MD,
  3. Jiaxin Yang, MD*,
  4. Dongyan Cao, MD*,
  5. Huimin Bai, MD*,
  6. Huifang Huang, MD*,
  7. Ming Wu, MD*,
  8. Jie Chen, MD,
  9. Jinghe Lang, MD* and
  10. Keng Shen, MD*
  1. *Departments of Obstetrics and Gynecology and
  2. Departments of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
  3. &Departments of Peking Union Medical College, Beijing, China.
  1. Address correspondence and reprint requests to Keng Shen, MD, No 1 Shuaifuyuan Rd, Dongcheng District, Beijing, China, 100730. E-mail:


Objective This study aimed to analyze the clinicopathological features of pure and mixed-type ovarian clear cell carcinoma (CCC) in Chinese patients.

Methods Patients with ovarian CCC treated in our institution between 1982 and 2012 were identified by reviewing the database and medical charts. Patients were assigned into 2 groups based on histology (pure or mixed). Comparison of clinicopathological parameters was performed to determine the similarities and/or differences between pure and mixed CCC. Kaplan-Meier model was used in survival analysis.

Results Of 341 patients with ovarian CCC, 46 (13.5%) mixed tumors were identified, and the most common combination was clear cell/endometrioid, accounting for 56.5%. Patients with mixed-type CCC tended to have higher level of serum cancer antigen 125 (P = 0.023) and advanced tumor stage (P = 0.001). No difference was observed in other features including age, tumor size, residual disease, lymph node metastasis, and coexisting endometriosis. Tumor recurrence occurred in 47.8% and 58.1% in patients with pure and mixed histology, respectively (P = 0.209). Two groups had comparable platinum-sensitive disease (42.1% in pure and 44.0% in mixed type, P = 0.860). Patients with pure CCC had an improved median survival (105 vs 56 months), although statistical significance was not achieved. Histology subclassification of mixed tumor revealed that patients with clear cell/endometrioid histology had better survival outcome than those with clear cell/serous type (median survival, 140 vs 43 months, P = 0.004; median progression-free survival, 49 vs 12 months, P = 0.001).

Conclusions Patients with mixed CCC tended to have elevated serum cancer antigen 125 and advanced tumor stage. However, no significant difference was observed between the pure and mixed tumors regarding prognosis.

  • Clear cell
  • Ovarian carcinoma
  • Clinicopathological features
  • Prognosis

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  • This study was supported by the National High Technology Research Development Program of China (863 program, Grant 2012AA02A507) and National Natural Science Foundation of China (Grant 81172482 and Grant 81372780).

  • The authors declare no conflicts of interest.