术前血清CA125、凝血酶原时间对上皮性卵巢癌预后及铂耐药的预测价值

Predictive value of preoperative CA125 and PT on prognosis and platinum resistance in epithelial ovarian cancer

目的:研究卵巢癌患者术前血清CA125和凝血酶原时间(PT)与对上皮性卵巢癌颈后及铂耐药的预测价值。方法:选取收治的348例上皮性卵巢癌患者为研究对象,且于术后均接受以铂类为主的化疗方案,根据铂耐药/敏感分为铂耐药组(n=43)与铂敏感组(n=305)。通过独立样本t检验分析CA125、PT与临床病理各因素的相关性;Kaplan-Meier生存曲线评估与生存的相关性;采用受试者工作特征(ROC)曲线评估血清CA125、PT的诊断效能;χ^(2)检验分析CA125、PT与铂耐药的相关性。结果:不同FIGO分期(P=0.001)、有无腹水(P<0.001)、生存状态(P<0.001)及铂耐药(P<0.001)PT平均值差异有统计学意义;有无腹水(P=0.002)、生存状态(P<0.001)及铂耐药(P<0.001)CA125平均值差异有统计学意义;高水平的CA125、PT患者的总生存率(OS)较差,且是铂耐药的危险因素,两者联合检测对评估卵巢癌预后及铂耐药的效果更好。结论:术前血清CA125、PT水平升高是卵巢癌发生铂耐药的危险因素,且与卵巢癌预后不良相关。

Objective To study on the predictive value of preoperative serum cancer antigen 125(CA125)and prothrombin time(PT)in epithelial ovarian cancer patients for prognosis and platinum resistance.Method 348 patients with epithelial ovarian cancer admitted to our hospital were selected as research object,and all received platinum-based chemotherapy regimens after surgery,and divided into 43 cases in the platinum-resistant group and 305 cases in the platinum-sensitive group according to platinum sensitivity/resistance.The correlation between CA125,PT and clinicopathological factors was analyzed by independent sample t-test;the correlation with survival was assessed by Kaplan-Meier survival curve;assessment of the diagnostic efficacy of serum CA125 and PT using subject operating characteristic(ROC)curves;the correlation between CA125,PT and platinum resistance was analyzed by chi-square test.Results The differences in mean values of PT with different FIGO stages(P=0.001),with or without ascites(P<0.001),survival status(P<0.001)and platinum resistance(P<0.001)were statistically significant;the differences in mean values of CA125 with or without ascites(P=0.002),survival status(P<0.001)and platinum resistance(P<0.001)were statistically significant;high level of CA125 and PT patients had poor overall survival(OS)and were risk factors for platinum resistance,and the combination of both tests was better for assessing the prognosis of ovarian cancer and platinum resistance.Conclusion Elevated preoperative serum CA125 and PT levels are risk factors for the development of platinum resistance in ovarian cancer,and are associated with poor prognosis in ovarian cancer.