卵巢癌铂耐药复发相关临床因素研究

Study on the clinical factors of recurrence of platinum resistance in ovarian cancer

目的分析影响卵巢癌铂耐药复发的相关临床因素,为临床制定治疗方案提供一定的理论依据。方法回顾性分析2015年2月至2020年2月武警四川省总队医院住院治疗的188例复发性卵巢癌患者的临床资料,根据复发类型分为35例铂耐药复发性卵巢癌组(铂耐药组)和153例铂敏感复发性卵巢癌组(铂敏感组)。收集两组患者的相关临床资料,采用单因素分析和多因素logistic回归分析影响卵巢癌铂耐药复发的危险因素。结果两组年龄、手术病理分期、化疗疗程、采用新辅助化疗、手术彻底性、初诊时人附睾蛋白4水平、缺氧诱导因子-1α表达阳性率、组蛋白赖氨酸去甲基化酶5A表达阳性率比较,差异有显著性(P<0.05);手术彻底性、肿瘤负荷、新辅助化疗、人附睾蛋白4水平属于影响卵巢癌铂耐药复发的独立危险因素。结论影响卵巢癌铂耐药复发的临床因素较多,其中手术彻底性、肿瘤负荷、新辅助化疗、人附睾蛋白4水平、缺氧诱导因子-1α表达阳性、组蛋白赖氨酸去甲基化酶5A表达阳性属于影响卵巢癌铂耐药复发的独立危险因素。临床可根据危险因素制定相应的治疗方案以提高临床疗效。

Objective To analyze the related clinical factors affecting the recurrence of platinum resistance in ovarian cancer,and to provide some theoretical basis for the clinical treatment plan.Method The clinical data of 188 patients with recurrent ovarian cancer hospitalized in our hospital from February 2015 to February 2020 were retrospectively analyzed.According to the type of recurrence,the patients were divided into 35 cases of platinum resistant recurrent ovarian cancer group(platinum resistant group)and 153 cases of platinum sensitive recurrent ovarian cancer group(platinum sensitive group).The related clinical data of the two groups of patients were collected.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors for platinum resistance recurrence of ovarian cancer.Results There were significant differences in age,surgical pathological stage,chemotherapy course,neoadjuvant chemotherapy,surgical thorougness,human epididymal protein 4 level at first diagnosis,the expression rate of hypoxia-inducing factor-1α(HIF-1α),and the expression rate of histomine lysine demethylase 5A(KDM5A)compared with the platinum-sensitive group(P<0.05);Surgical thoroughness,tumor load,neoadjuvant chemotherapy and HE4 level are independent risk factors affecting the recurrence of platinum-resistant ovarian cancer.Conclusions There were many clinical factors affecting the recurrence of platinum resistance in ovarian cancer,among which the thoroughness of surgery,tumor load,neoadjuvant chemotherapy,HE4 level,positive expression of HIF-1αand positive expression of KDM5A are independent risk factors affecting the recurrence of platinum resistance in ovarian cancer.Clinical treatment can be made according to risk factors to improve clinical efficacy.