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Ⅲ期卵巢上皮性癌复发的相关因素分析

周立香1,张虹2   

  1. 1. 天津医科大学研究生院
    2. 天津市中心妇产科医院
  • 收稿日期:2011-10-11 修回日期:2012-03-28 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 周立香

Clinical investigation of recurrent ovarian epithelial cancer in Ⅲ stage

  • Received:2011-10-11 Revised:2012-03-28 Published:2013-01-15 Online:2013-01-15

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摘要：

【摘要】 目的探讨影响Ⅲ期上皮性卵巢癌复发的相关因素。方法选取Ⅲ期上皮性卵巢癌85例,其中复发组31例,未复发组54例。测定并比较2组患者的纤维蛋白原(FIB)含量、部分凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶原时间(APTT)、血小板计数(PLT)、血清癌抗原125(CA125)、术中腹水量、腹水肿瘤细胞学性质、FIGO分期、组织学类型及组织学分级、残留灶大小、术中盆腔或(和)腹主动脉淋巴结是否切除及术后2个月CA125下降情况。Logistic回归分析影响复发的相关因素。结果复发组术前PT、TT缩短,腹水肿瘤细胞学阳性率、≥2cm残留癌灶所占比例、未行淋巴结切除术及术后2个月CA125未降至正常所占比例与未复发组比较差异有统计学意义(P<0.05或P<0.01),多因素Logistic回归分析显示残留肿瘤≥2cm、腹水肿瘤细胞学阳性、术中未行淋巴结切除及术后2个月CA125未正常是复发的独立危险因素。结论残留灶大小、腹水肿瘤细胞学性质、淋巴结是否切除及术后2个月血清CA125水平可以作为预测Ⅲ期卵巢上皮性癌复发的重要参考因素。

关键词: 卵巢上皮性癌, CA125, 复发, 淋巴结切除术, Logistic模型

Abstract: Objective：To discuss the possible causes of recurrent ovarian epithelial cancer in Ⅲ stage Methods：A total of 85 ovarian epithelial cancer patients in Ⅲ stage were allocated to recurrent group （31patients） and non-recurrent group （54 patients）. CA-7000 automated coagulation analyzer was used to examine the level of plasma fibrinogen （FIB）, plasma prothrombin time（PT）, thrombin time（TT）, activated partial thromboplastin time（APTT）, PLT was measured by Sysmex KX-21; CA125 was measured by electro-chemiluminescence, volume and quality of ascites, FIGO substages, histological type and grades, size of residual tumor during operation, pelvic or abdominal lymph node resectable or not and CA125 level of plasma 2 months after operation. Univariate analysis and multivariate logistic regression analysis were used to differentiate between recurrence and non-recurrence patients. Result：In univariate analysis, there was significant difference in the level of PT and TT, the rate of positive peritoneal cytology, the rate of ≥2cm residual tumor, the rate of lymph node unresected and the rate of CA125 not declined to normal 2 months later after operation between patients of recurrence and non-recurrence（P<0.05）. Multivariate analysis showed that ≥2cm residual tumor， the rate of positive peritoneal cytology, the rate of lymph node unresected and CA125 not declined to normal 2 months later after operation were important dangerous factors for recurrence of patients in Ⅲ stage（P<0.05）. conclusion：In patients of ovarian epithelial cancer in Ⅲ stage， residual tumor, peritoneal cytology, lymph node resected or not and CA125 level 2 months after operation were important prognostic factors of recurrence.

Key words: ovarian epithelial cancer, CA125, recurrence, lymph node resection, Logistic models