血小板计数及纤维蛋白原水平与卵巢上皮性癌临床病理因素的 相关性及其对预后的影响

Prevalence and prognostic value of platelets and fibrinogen in preoperative patients with epithelial ovarian cancer

目的:研究血小板计数及纤维蛋白原(fibrinogen,FIB)水平与卵巢上皮性癌临床病理因素之间的相关性及其对预后的影响。方法:选取2012年6月至2016年6月在连云港妇幼保健院住院手术的卵巢上皮性肿瘤患者297例,其中卵巢上皮性癌患者137例,卵巢上皮性良性肿瘤患者160例作为对照。回顾性分析卵巢上皮性癌患者的临床病理资料以及良性肿瘤患者的年龄、术前血常规、凝血功能,术后病理资料等。计算血小板及FIB增多在卵巢良恶性肿瘤中的发生率,以及其与卵巢上皮性癌患者临床病理因素之间的相关性;所有卵巢上皮性癌患者随访至2017年6月,计算其总生存期(overall survival,OS)及无进展生存期(progress-free survival,PFS),分析血小板及FIB增多与其预后的关系。结果:卵巢上皮性癌患者血小板及FIB含量显著高于卵巢良性肿瘤患者,差异有统计学意义(P<0.05)。FIGO手术–病理分期越晚、分化程度越低、腹水量越多、术后残留肿瘤越大、术前CA125水平越高、术前肿瘤体积越小的患者合并血小板增多的发生率越高(P<0.05);FIB增多与FIGO手术–病理分期、腹水量、术后残留肿瘤大小及术前CA125水平有一定的相关性(P<0.05)。血小板增多是卵巢上皮性癌患者PFS的独立不良预后因子(P<0.05)。FIB增多与卵巢上皮性癌患者的预后无相关性。结论:血小板及FIB增多是卵巢上皮性癌常见现象之一,这可能与肿瘤的侵袭、转移相关;血小板增多是卵巢上皮性癌不良预后的危险因子。

Objective： To evaluate the prevalence and prognostic value of platelets and fibrinogen in preoperative patients with epithelial ovarian cancer （EOC）. Methods： This study enrolled 297 patients with epithelial ovarian tumor admitted to our hospital from June 2012 to June 2016 who underwent operative therapy, among which 137 patients were malignance as the experimental group and 160 were benign as the control group. We retrospectively collected the basic information of EOC, including age, preoperative laboratory tests （blood routine, coagulation function and CA-125）, the volume of ascites and tumor size measured during the surgery, postoperative pathologic records, and analyzed the correlation between thrombocytosis and high fibrinogen with clinical pathologic factors by evaluating the incidence of thrombocytosis and high fibrinogen. All patients diagnosed with EOC were followed to June 2017, the overall survival （OS） and progression free survival （PFS） were calculated, and the relationship between thrombocytosis and high fibrinogen and prognosis was analyzed. Results： The content of platelets and fibrinogen in patients with EOC was significantly higher than that in patients with benign ovarian tumors （P〈0.05）. International Federation of Gynecology and Obstetrics （FIGO） pathological stage is later, the lower the degree of differentiation, the amount of ascites, more postoperative residual tumor size, preoperative CA125 level, preoperative tumor volume smaller in patients with thrombocytosis rate was higher （P〈0.05）; fibrinogen increased with FIGO pathological stage, ascites the amount of postoperative residual correlated with tumor size and preoperative CA125 level （P〈0.05）. ＂I-hrombocytosis is an independent prognostic factor for progression free survival in patients with epithelial ovarian cancer （P〈0.05）. There is no correlation between fibrinogen and prognosis in patients with epithelial ovarian cancer. Conclusion： ＂l-hrombocytosis and high fibrinogen are prevalent in patients with EOC, which may owe to the invasion and metastasis of cancer. Thrombocytosis is an unfavorable prognostic factor of survival in patients with EOC.