影响上皮性卵巢癌患者满意肿瘤细胞减灭术的相关因素分析

Characteristics and related factors of theunsatisfactorydebulking surgery in advanced epithelial ovarian carcinoma

目的探讨影响上皮性卵巢癌满意肿瘤细胞减灭的相关因素。方法回顾性分析行初次卵巢肿瘤细胞减灭并经术后病理确诊的上皮性卵巢癌94例患者的临床病理资料。以满意肿瘤细胞减灭术[无肉眼残留病灶(R0)与残留病灶≤1 cm(R1)]为金标准,将患者分为满意肿瘤细胞减灭术组60例(R0+R1组),不满意肿瘤细胞减灭术组34例(R2组)。通过单因素χ2分析及二元Logistics回归分析比较2组患者的临床病理资料(年龄、绝经状况、病理类型、FIGO分期、血清学肿瘤标记物等)与满意肿瘤细胞减灭术的相关性。结果94例上皮性卵巢癌患者中满意组60例(63.83%),不满意肿瘤细胞减灭术组34例(36.17%)。患者年龄>60岁、大量腹水、FIGOⅢ~Ⅳ期在2组间比较差异均有统计学意义(χ2=12.184,P<0.05),为满意肿瘤减灭术的危险因素。不满意组术前血清肿瘤标记物糖类抗原125(CA125)及术前血清人附睾分泌蛋白4(HE4)水平均显著高于满意组(P<0.05)。术前CA125>500 U/mL、术前HE4>262 pmol/L在2组间差异有统计学意义(P<0.05),且均为满意肿瘤减灭术的危险因素。CA125>500 U/mL、大量腹水为满意肿瘤细胞减灭术的独立危险因素(P<0.05)。结论是否能行满意肿瘤细胞减灭术与患者年龄>60岁、大量腹水、FIGOⅢ~Ⅳ期、术前CA125>500 U/mL、术前HE4>262 pmol/L明显相关,术前充分评估这些因素可提高满意肿瘤细胞减灭术的比率。

Objective To analyze the relationship between the clinical characteristics of patients with advanced ovarian cancer in our hospital and unsatisfactory debulking surgery.Methods The clinical data of 61 patients with advanced epithelial ovarian cancer diagnosed by pathology were collected.Satisfactory debulking surgery(no residual focus(no residual disease R0)and residual disease≤1 cm)as the gold standard,The patients were divided into 31 cases of satisfactory debulking surgery group,Dissatisfied debulking surgery group 30 cases,Clinical and pathological data(age,menopausal status,pathological type,FIGO stage,serological tumor markers,etc.).The correlation between clinical and pathological features and unsatisfactory debulking surgery was determined by chi-square analysis.Results 94 patients with epithelial ovarian cancer,64 patients had satisfied debulking surgery(68.08%)and 30 patients were dissatisfied with debulking surgery(31.91%).The age>60 years old,massive ascites,FIGOⅢ-Ⅳ,preoperative CA125>500 U/ml,preoperative HE4 greater than 262 pmol/L.If the pathology of the patients was serous carcinoma,there was no statistical difference between the groups.CA125>500 U/ml and massive ascites were independent risk factors for satisfactory tumor cell ablation(OR:4.442,P<0.05).Conclusion Satisfactory debulking surgery is related to the patient′s age>60 years old,massive ascites,FIGOⅢ-Ⅳperiod,preoperative CA125>500 U/ml,preoperative HE4 greater than 262 pmol/L.Adequate preoperative evaluation may have a certain effect on satisfactory debulking surgery.