全腹CT评分与Fagotti评分对晚期卵巢癌患者行R0减灭术术前评估的效果比较

Comparative study of whole abdominal CT score and Fagotti score in preoperative evaluation of R0 cytoreductive surgery in patients with advanced ovarian cancer

目的对比全腹CT评分与Fagotti评分在晚期卵巢癌(OC)患者行R0减灭术术前评估中的效果。方法选取2021年1月至2022年6月新疆维吾尔自治区人民医院收治的60例晚期OC患者作为研究对象,均行全腹CT评分,之后对患者行腹腔镜探查术,术中行Fagotti评分。对比不同Fagotti评分患者的基线资料及全腹CT评分,分析Fagotti评分的影响因素,对比两种评分对晚期OC患者行R0减灭术术前评估效果的一致性。结果60例患者全腹CT评分为0~9分,平均(3.05±1.02)分。≥3分者27例,占45.00%;<3分者占33例,占55.00%。Fagotti评分为0~14分,平均(7.79±2.01)分。≥8分者29例,占48.33%;<8分者占31例,占51.67%。校正国际妇产科联盟(FIGO)分期、肿瘤位置、分化程度、恶性腹水因素后,晚期OC患者全腹CT评分仍与Fagotti评分有关(P<0.05);全腹CT评分与Fagotti评分术前评估晚期OC患者行R0减灭术具有较高的一致性(Kappa指数=0.799,95%CI:0.547~1.052,χ^(2)=35.353,P<0.001)。结论全腹CT评分与Fagotti评分在术前评估晚期OC患者行R0减灭术方面具有较高的一致性,全腹CT评分在一定程度上可取代Fagotti评分对晚期OC患者行R0减灭术的术前评估。

Objective To compare whole abdominal CT score and Fagotti score in preoperative evaluation of R0 cytoreductive surgery in patients with advanced ovarian cancer(OC).Methods A total of 60 patients with advanced OC admitted to Xinjiang People's Hospital from January 2021 to June 2022 were selected as study objects.Whole abdominal CT scoring was performed in all patients,and then laparoscopic exploration was performed on the patients,and Fagotti score was performed during the operation.The baseline data and whole abdominal CT scores of patients with different Fagotti scores were compared.The influencing factors of Fagotti score were analyzed.The consistency of the two scores in preoperative evaluation of R0 cytoreductive surgery in advanced OC patients was assessed.Results The total abdominal CT score of 60 cases was 0-9 points,with an average of(3.05±1.02)points.27 cases were≥3 points,accounting for 45.00%,and 33 cases were<3 points,accounting for 55.00%.The Fagotti score was 0-14 points,with an average of(7.79±2.01)points.29 cases were≥8 points,accounting for 48.33%,and 31 cases were<8 points,accounting for 51.67%.After adjusting for international federation of gynecology and obstetrics(FIGO)stage,tumor location,degree of differentiation,and malignant ascites,the whole abdominal CT score of patients with advanced OC was still related to the Fagotti score(P<0.05).Whole abdominal CT score and Fagotti score were highly consistent in preoperative evaluation of advanced OC undergoing R0 cytoreductive surgery(Kappa index=0.799,95%CI:0.547-1.052,χ^(2)=35.353,P<0.001).Conclusions Whole abdominal CT score and Fagotti score were highly consistent in preoperative evaluation of R0 cytoreductive surgery for advanced OC.To a certain extent,the whole abdominal CT score can replace the Fagotti score in the preoperative evaluation of R0 cytoreductive surgery in advanced OC.