浆液性卵巢癌染色体异常与预后关系

RELATIONSHIP BETWEEN CHROMOSOME CHANGES AND PROGNOSIS IN OVARIAN SEROUS ADENOCARCINOMA

目的 探讨浆液性卵巢癌染色体畸变与预后关系。方法 直接法分析97例浆液性卵巢癌体腔液或瘤内细胞G带梁色体。结果 复杂畸变组49例，生存率极显著低于48例简单畸变者（P＜0．001）。21例带瘤存活者中复杂畸变检出率71．43％，极显著高于无瘤存活者中的18．18％（P＜0．001）。11个变量经COX模型多因素分析显示，化疗前后总染色体结果有独立预后意义（P＜0．001），而病理分级可能有独立预后意义（P＝0．053）。23例化疗前后动态观察显示，化疗后畸变细胞比例升值率极显著负相关于生存期（r＝－0．5786，P＜0．005）。结论 浆液性卵巢癌复杂染色体畸变可作为独立的不良预后因素；化疗前后动态染色体将有助于卵巢癌个体化预后评价。

Objective To explore the correlation of chromosome changes and the prognosis in ovarian serous adencocarcinoma． Methods G－banded chromosomes from effusions or tumours were directly prepared and analyzed in 97 patients with ovarian serous adenocarcinoma． Differences between the Kaplan－Meier survival rates were assessed by log－rank test． Result In overall chromosome examinations from prechemotherapy through postchemotherapy the complex aberration group 49 cases was found an obviously lower survival rate than the simple one 48 cases P＜0．001． In the tumour－bearing survivors 71．43％ 15／21 of patients were seen with complex aberrations significantly higher than 18．18％ 8／44 in the tumour－free survivors P＜0．001． When 11 variates were entered into cox models the overall chromosome examinations were revealed by multivariate analysis related independently to prognosis P＜0．001 while the tumour grade to be likely of independent prognostic meaning P＝0．053． On individually contrast observations between the pre－ and post－chemotherapy were obviously showed to be negatively correlative to survivals r＝－0．5786 P＜0．005． Conclusion The complex chromosomal aberration may be an independent nocuous prognosticator． Analysis of chromosome changes before and after chemotherapy could be of benefit to prognostic assessment individually．