卵巢癌患者肿瘤细胞减灭术后复发的影响因素

Influencing factors of recurrence after cytoreductive surgery in patients with ovarian cancer

目的分析卵巢癌(OC)患者肿瘤细胞减灭术(CRS)后复发的影响因素。方法回顾性收集107例OC患者的资料,所有患者均完成CRS治疗,并随访2年。根据术后2年内肿瘤复发情况将患者分为复发组和未复发组。采用Logistic回归分析探讨导致OC患者CRS术后复发的影响因素。结果107例OC患者中,CRS术后68例复发,复发率为63.55%;复发组患者乳腺癌易感基因-1(BRCA-1)、聚腺苷二磷酸核糖聚合酶-1(PARP-1)表达、残瘤直径、术中淋巴结清扫、糖类抗原125(CA125)水平、人附睾分泌蛋白4(HE4)水平与未复发组比较,差异有统计学意义(P<0.05);复发组和未复发组OC患者的年龄、肿瘤直径、国际妇产科联合会(FIGO)分期、组织分型、产次、术前绝经、淋巴结转移、不同分化程度肿瘤细胞占比、血清糖类抗原199(CA199)、癌胚抗原(CEA)比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,BRCA-1阳性表达、PARP-1阳性表达、残瘤直径>1 cm、术中未清扫淋巴结、CA125水平升高、HE4水平升高可能是OC患者CRS术后复发的危险因素(OR>1,P<0.05)。结论BRCA-1阳性表达、PARP-1阳性表达、残瘤直径>1 cm、术中未清扫淋巴结、CA125水平升高、HE4水平升高可能是OC患者CRS术后复发的危险因素。

Objective To analyze the influencing factors of recurrence after cytoreductive surgery(CRS) in patients with ovarian cancer(OC). Methods Data of 107 OC patients were retrospectively collected, and all patients completed CRS treatment and were followed up for 2 years. These patients were divided into recurrence group and non-recurrence group according to tumor recurrence within 2 years after surgery. Logistic regression analysis was used to investigate the influencing factors of postoperative recurrence of CRS in OC patients. Results Among 107 OC patients, 68 patients relapsed after CRS, with a recurrence rate of 63.55%. The expression of breast cancer susceptibility gene-1(BRCA-1), poly adenosine diphosphate ribose polymerase-1(PARP-1), residual tumor diameter, intraoperative lymph node dissection, carbohydrate antigen 125(CA125) level and human epididymal protein 4(HE4) level showed significant differences between the recurrence group and the non-recurrence group(P<0.05). Compared age, tumor diameter, International Federation of Gynecology and Obstetrics(FIGO) stage, disease type, histological type, delivery times, preoperative menopause, lymph node metastasis, proportion of tumor cells with different degrees of differentiation, serum CA199 and carcinoembryonic antigen(CEA) between recurrent and non-recurrent OC patients, there was no statistical significant difference(P>0.05). Logistic regression analysis showed that BRCA-1 positive expression, PARP-1 positive expression, residual tumor diameter >1 cm, unperformed intraoperative lymph node dissection, increased CA125 and HE4 levels might be the influencing factors of postoperative recurrence after CRS in OC patients(OR>1,P<0.05).Conclusion BRCA-1 positive expression, PARP-1 positive expression, residual tumor diameter >1 cm, intraoperative uncleaned lymph nodes, increased CA125 and HE4 levels may be the risk factors of postoperative recurrence after CRS in OC patients.