影响老年复发卵巢上皮性癌患者预后的临床病理因素分析

The analysis of clinical pathologic factors influencing the prognosis of elderly patients with recurrent epithelial ovarian cancer

目的探讨病理因素在判断老年复发卵巢上皮性癌患者预后中的价值。方法随机在本院选择150例明确诊断为老年复发卵巢上皮性癌患者，收集总结此类患者的一般信息、治病经过、疗效观察、生存状态等，采用Kaplan—meier生存曲线、Logrank检验以及Cox模型多因素回归分析法三种方法。研究影响老年复发卵巢上皮性癌患者预后的因素。结果影响老年复发卵巢上皮性癌患者预后的单因素主要是复发部位、复发距离末次化疗时间、复发后伴有腹水、FIGO分期、最大复发病灶、再次治疗化疗方案、CA125升高、复发后二次肿瘤细胞减灭术、化疗疗程（P〈0．05），年龄、组织分化与预后无关（P〉0．05）。采用Cox模型多因素回归分析法研究影响老年复发卵巢上皮性癌患者预后的单因素发现，复发后再次化疗疗程、复发后伴腹水、复发部位为独立危险因素。调查试验者的总体中位生存时间，结果显示为19个月（95％CI：15．956—20．143）。结论老年复发卵巢上皮性癌预后临床病理因素主要是复发后再次化疗疗程、复发后伴腹水、复发部位等为独立危险因素，临床医生应严格把握临床指征，尽量避免影响患者预后，准确判断患者的状态。

Objective To explore the value of pathological factors in judging the prognosis of elderly patients with recurrent epithelial ovarian cancer. Methods 150 patients with recurrent epithelial ovarian cancer were randomly selected in our hospital, and their general information, treatment courses, curative effect observation, living conditions, etc were collected. Kaplan-meier survival curve, Log rank test, and Cox model multi factor regression analysis were used to study the factors influencing the prognosis of elderly patients with recurrent epithelial ovarian cancer. Results The single factors influencing the prognosis of elderly patients with recurrent epithelial ovarian cancer were mainly recurrent site, the time from recurrence to chemotherapy, ascites after recurrence, FIGO staging, maximum recurrent focus, chemotherapy regimen, increased CA125, two times of cytoreductive surgery after recurrence, the course of chemotherapy （P〈0.05）, age, histological differentiation were not associated with the prognosis （P〉0.05）. Cox model multi factor regression analysis showed that the course of chemotherapy after recurrence, ascites after recurrence, recurrent site were independent risk factors influencing the prognosis of elderly patients with recurrent epithelial ovarian cancer. The overall median survival time of investigators was 19 months （95%CI： 15.956-20.143）. Conclusions Clinicopathological factors influencing the prognosis of recurrent epithelial ovarian cancer in the elderly are the course of chemotherapy after recurrence, ascites after recurrence, recurrence site, and they are all independent risk factors. Clinicians should strictly grasp the clinical indications, judge the patients＇ condition accurately, and avoid affecting the prognosis of patients as far as possible.