Epithelial Ovarian Cancer Patients and Clinicopathological Features and Survival: A Comparison of Outcomes of Two Age Cohorts in Bangladesh

Objective: This study compared the clinicopathologic characteristics and overall survival of epithelial ovarian carcinoma in women younger versus older than 45 years in Bangladesh. Methods: A retrospective analysis identified 129 epithelial ovarian carcinoma patients who were admitted to the National Institute of Cancer Research and Hospital, in Dhaka, Bangladesh from 2016 through 2017 for surgery. These patients were grouped into two categories: the younger group (≤45 years) and the older group (>45 years). Clinicopathological features of epithelial ovarian carcinoma were analyzed in each age group. Cox proportional hazards model identified factors affecting survival and Kaplan-Meier survival curves with log rank test compared outcomes for each age group. Results: The median age of the 129 women was 46 years (IQR: 38, 56) and median time of follow-up was 9 months (inter-quartile range: 4, 26.5). We found a significant difference in the CA-125 level (p < 0.044), age of menopause (p < 0.001), follow-up duration (p < 0.016), disease outcome (p < 0.005) and histopathological type (p < 0.021) between the two groups. No significant differences were found in breakdown of Federation of Gynecology and Obstetrics (FIGO) stage of the disease. There was a significant difference in overall survival between the patients of two groups (p = 0.021) where there was a higher probability of death among the older cohort. The 5-year overall survival rates for the younger age versus older group were 34.0%, and 11.7% respectively. Independent prognostic factors by univariate analysis for the overall survival were age, FIGO stage, preoperative CA-125 and CEA level. However, when controlling for stage, survival was similar between age cohorts. Conclusions: Our data suggests that women in Bangladesh with epithelial ovarian cancer who are under the age of 45 years have a different clinical profile and better overall survival than women in the older age cohort.

Association of serum lipids and severity of epithelial ovarian cancer：an observational cohort study of 349 Chinese patients

While obesity and fat intake have been associated with the risk and prognosis of epithelial ovarian cancer, the association between the lipid levels and epithelial ovarian cancer phenotype remains controversial. We conducted a retrospective study of 349 epithelial ovarian cancer patients who received treatment at Jiangsu Cancer Hospital, China between 2011 and 2017. We analyzed age at diagnosis, blood pressure, plasma glucose content, body mass index（BMI）, lipid levels and clinical parameters. Severity of epithelial ovarian cancer was classified according to the International Federation of Gynecology and Obstetrics（FIGO） grading system. Univariate analysis of the clinical factors according to the severity of epithelial ovarian cancer was followed by logistic regression analysis to identify clinical factors significantly associated with epithelial ovarian cancer severity. Univariate analysis indicated that age,BMI, triglyceride（TG）, and high density lipoproteins（HDL） differed significantly among different stages of epithelial ovarian cancer（P〈0.05）. In the logistic regression model, elevated TG（OR： 1.883; 95% CI= 1.207-2.937）, and low HDL（OR： 0.497; 95% CI = 0.298-0.829） levels were significantly associated with the high severity epithelial ovarian cancer. Our data indicate that high TG and low HDL levels correlate with a high severity of epithelial ovarian cancer. These data provide important insight into the potential relationship between the lipid pathway and epithelial ovarian cancer phenotype and development.

Prognosis in epithelial ovarian cancer: Clinical analysis of 287 pelvic and para-aortic lymphadenectomy

Objective: To evaluate the relationship between the pelvic and para-aortic lymphadenectomy and the prognosis of epithelial ovarian cancer. Methods: 287 patients suffering from primary epithelial ovarian cancer from 1995 to 2005 were analyzed retrospectively. Results: The 3-, 5-, 10-year survival with systematic lymphadenectomy (SL) were slightly higher than those without SL, but there were no statistically significance (P > 0.05). The 3-, 5-, 10-year survival of clinical stages without SL were lower than those with SL, but there were no significant difference either (P > 0.05). The 3-,5-, and 10-year survival rates with SL were higher than those without SL with no statistically differences (P > 0.05) among the subgroups such as absent, ≤ 2 cm and > 2 cm residual tumor. The survival rates of the groups without residual tumor and the group with ≤ 2 cm residual tumor were significantly higher than that of > 2 cm (P < 0.005). On multivariate analysis, patient staging (P = 0.01) and size of residual disease after primary cytoreductive surgery (P < 0.001 and = 0.002, respectively) retained prognostic significance. SL was not proved to be an independent prognostic factor (P = 0.69). Conclusion: Systematic pelvic and para-aortic lymphadenectomy can not improve and prolong the survival time significantly.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in epithelial ovarian cancer: State of the art

Advanced stage epithelial ovarian cancer(EOC) is diffi cult to treat with low overall cure rates. A new strategy combining maximal cytoreductive surgery(CRS) with intraoperative hyperthermic intraperitoneal chemotherapy(HIPEC) has been proposed to treat advanced stage EOC in the primary setting. Numerous small, heterogeneous studies have been conducted exploring outcomes in patients with predominantly advanced, recurrent or refractory disease treated with CRS + HIPEC. Although morbidity rates approaching 35% have been reported, oncologic outcomes are promising. Incorporation of HIPEC for the treatment of primary EOC has continued to gain interest. Several prospective phase 2 clinical trials were recently completed evaluating the impact of CRS + HIPEC in the primary setting. This article will briefl y discuss the benefi ts of optimal surgical cytoreduction and the theoretical basis of intraperitoneal chemotherapy in patients with advanced stage EOC, and will then review existing literature describing oncologic outcomes in EOC patients treated with HIPEC in the primary setting.

Adjuvant Chemotherapy May Not Be Necessary for Women with Stage IC1 Epithelial Ovarian Cancer

Objective:To determine whether adjuvant chemotherapy improves the prognoses in women with stage IC1 epithelial ovarian cancer(EOC).Methods:All eligible women diagnosed with stage IC1 EOC from 2003 to 2019 in Tongji Hospital were included.Patient characteristics,tumor features,surgical types,and chemotherapeutic treatments were collected.Kaplan-Meier analysis and Cox regression analysis were performed to evaluate progression-free survival(PFS)and overall survival(OS).

Clinical characteristics and survival of patients with normal-sized ovarian carcinoma syndrome: Retrospective analysis of a single institution 10-year experiment

BACKGROUND Normal size ovarian cancer syndrome(NOCS)is a challenge for clinicians regarding timely diagnosis and management due to atypical clinical and imaging features.It is extremely rare with only a few cases reported in the literature.More data are needed to clarify its biological behavior and compare the differences with abnormal size ovarian cancer.AIM To assess the clinical and pathological features of NOCS patients treated in our institution in the last 10 years and to explore risk factors for relapse and survival.METHODS Patients who were pathologically diagnosed with NOCS between 2008 and 2018 were included.Papillary serous ovarian carcinoma(PSOC)patients were initially randomly recruited as the control group.Demographics,tumor characteristics,treatment procedures,and clinical follow-up were retrospectively collected.Risk factors for progression-free survival and overall survival were assessed.RESULTS A total of 110 NOCS patients were included;80(72.7%)had primary adnexal carcinoma,two(1.8%)had mesotheliomas,18(16.4%)had extraovarian peritoneal serous papillary carcinoma,and eight(7.3%)had metastatic tumors.Carbohydrate antigen(CA)125 and ascites quantity were lower in the NOCS cohort than in the PSOC group.The only statistically significant risk factors for worse overall survival(P<0.05)were the levels of CA199 and having fewer than six chemotherapy cycles.The 1-year,3-year,and 5-year survival rates were 75.5%,27.7%,and 13.8%,respectively.CONCLUSION The clinical symptoms of the NOCS group are atypical,and the misdiagnosis rate is high.Ascites cytology and laparoscopic exploration are valuable in the early diagnosis to avoid a misdiagnosis.The level of CA199 is the most important predictor of overall survival,and more than six cycles of chemotherapy contributes to the increased survival rates of NOCS patients.

Develop a nomogram to predict overall survival of patients with borderline ovarian tumors

BACKGROUND The prognosis of borderline ovarian tumors(BOTs)has been the concern of clinicians and patients.It is urgent to develop a model to predict the survival of patients with BOTs.AIM To construct a nomogram to predict the likelihood of overall survival(OS)in patients with BOTs.METHODS A total of 192 patients with histologically verified BOTs and 374 patients with epithelial ovarian cancer(EOC)were retrospectively investigated for clinical characteristics and survival outcomes.A 1:1 propensity score matching(PSM)analysis was performed to eliminate selection bias.Survival was analyzed by using the log-rank test and the restricted mean survival time(RMST).Next,univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors.In addition,a nomogram model was developed to predict the 1-,3-,and 5-year overall survival of patients with BOTs.The predictive performance of the model was assessed by using the concordance index(C-index),calibration curves,and decision curve analysis(DCA).RESULTS For clinical data,there was no significant difference in body mass index,preoperative CA199 concentration,or tumor localization between the BOTs group and EOC group.Women with BOTs were significantly younger than those with EOC.There was a significant difference in menopausal status,parity,preoperative serum CA125 concentration,Federation International of gynecology and obstetrics(FIGO)stage,and whether patients accepted postoperative adjuvant therapy between the BOT and EOC group.After PSM,patients with BOTs had better overall survival than patients with EOC(P value=0.0067);more importantly,the 5-year RMST of BOTs was longer than that of EOC(P value=0.0002,95%CI-1.137 to-0.263).Multivariate Cox regression analysis showed that diagnosed age and surgical type were independent risk factors for BOT patient OS(P value<0.05).A nomogram was developed based on diagnosed age,preoperative serum CA125 and CA199 Levels,surgical type,FIGO stage,and tumor size.Moreover,the c-index(0.959,95%confidence interval 0.8708–1.0472),calibration plot of 1-,3-,and 5-year OS,and decision curve analysis indicated the accurate predictive ability of this model.CONCLUSION Patients with BOTs had a better prognosis than patients with EOC.The nomogram we constructed might be helpful for clinicians in personalized treatment planning and patient counseling.

Primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery for patients with advanced ovarian cancer

Objectives： To compare the survival and perioperafive morbidity between primary debulking surgery （PDS） and neoadjuvant chemotherapy followed by interval debulking surgery （NAC/IDS） in treating patients with advanced epithelial ovarian cancer （EOC）. Methods： We retrospectively reviewed 67 patients with stage IIIC or iV EOC treated at Peking University Cancer Hospital from January 2006 to June 2009. VVherein, 37 and 30 patients underwent PDS and NAC/ IDS, respectively. Results： No difference in overall survival （OS） or progression-free survival （PFS） was observed between NAC/IDS group and PDS group （OS： 41.2 vs. 39.1 months, P=0.23; PFS： 27.1 vs. 24.3 months, P=0.37）. The optimal debulking rate was 60% in the NAC/IDS group, which was significantly higher than that in the PDS group （32.4%） （P=0.024）. The NAC/IDS group had significantly less intraoperative estimated blood loss and transfusion, lower nasogastric intubation rate, and earlier ambulation and recovery of intestinal function than the PDS group （P〈0.05）. Conclusions： NAC/IDS is less invasive than PDS, and offers the advantages regarding optimal cytoreduction rate, intraoperative blood loss, and postoperative recovery, without significantly impairing the survival compared with PDS in treating patients with stage IIIC or IV EOC. Therefore, NAC/IDS may be a valuable treatment alternative for EOC patients.

Does adding intraperitoneal paclitaxelto standard intraperitoneal regimenyield incremental survival？ A propensityscore？matched cohort study

We recruited consecutive patients with stage Ⅲ epithelial ovarian,tubal,and peritoneal cancers who had optimal residual tumor after primary cytoreductive surgery and who received intraperitoneal chemotherapy between 2002 and 2012.Two propensity score-matched sample cohorts were created.We found that the addition of paclitaxel as a second intraperitoneal agent on a 3-week dosing schedule did not yield significant incremental survival benefits over the intraperitoneal delivery of a single cisplatin-based regimen.If our findings could be confirmed by a prospective randomized study,then it would be interesting to explore the efficacy of shifting back to a dose-dense intraperitoneal delivery of paclitaxel or a dose-dense delivery of a new formulation of paclitaxel for the patients with stage III epithelial ovarian,tubal,and peritoneal cancers.

长链非编码RNA LUCAT1在上皮性卵巢癌组织中的表达及与患者预后的关系

目的探讨长链非编码RNA LUCAT1在上皮性卵巢癌组织中的表达及与患者预后的关系。方法选取黄石市中心医院2013年4月至2016年4月行手术治疗的125例上皮性卵巢癌患者的癌组织作为研究组,选取在同一医院同期行卵巢囊肿手术切除的47份正常卵巢组织作为对照组,采用实时荧光定量聚合酶链反应(PCR)检测组织中LUCAT1的表达,研究组患者术后随访至2021年4月30日,记录患者死亡情况及5年生存率。结果研究组上皮性卵巢癌组织中LUCAT1相对表达量高于对照组(2.27±0.19 vs.1.01±0.11,t=43.190,P<0.001);LUCAT1在不同组织学分级、国际妇产科联盟(FIGO)分期和淋巴结转移的上皮性卵巢癌组织中相对表达量差异具有统计学意义(P<0.05);低表达组患者平均生存时间(48.85±1.86)个月和5年生存率57.38%,高于高表达组的(30.06±2.59)个月和29.69%,差异具有统计学意义(χ2=19.787,P<0.001);LUCAT1表达量升高是患者生存时间的风险因素(P<0.05)。结论上皮性卵巢癌患者组织中LUCAT1表达量升高,且与组织学分级、FIGO分期和淋巴结转移相关,是影响患者预后的风险因素。

单中心卵巢癌患者5年生存率随访报告

目的:分析单一妇科肿瘤中心卵巢癌患者的生存情况,为卵巢癌诊治工作提供有用经验。方法:汇总2011年至2016年于山东大学齐鲁医院接受治疗的920例卵巢癌患者的临床数据及随访信息,所有患者随访周期超过5年或5年内出现不良结局事件,分析患者预后情况。结果:2011年至2016年本中心卵巢癌患者总体5年生存率为50.8%。结论:山东大学齐鲁医院卵巢癌患者总体5年生存率显著改善。

预测上皮性卵巢癌复发机器学习模型及列线图的建立

目的:本研究拟基于机器学习及Cox回归开发上皮性卵巢癌复发机器学习模型及列线图。方法:回顾性分析2010年01月至2020年12月于云南省肿瘤医院确诊739例Ⅲ-Ⅳ期EOC患者的医疗记录。收集患者的基本信息、手术、化疗细节和预后结果。使用单多因素逻辑回归及Cox回归筛选变量,使用5种机器学习算法基于单多因素逻辑回归的结果构建预测模型,采用10折交叉验证方法评估模型性能。基于Cox回归结果开发列线图。结果:739例患者中,399(54.0%)例最终发生了复发,340(46.0%)例未复发。复发患者分期以Ⅲ_(C)期为主,占59.1%,病理类型以浆液性癌为主,占91.0%。单多因素逻辑回归显示围手术期化疗周期、术后残余病灶、手术方式、新辅助化疗是与复发独立相关的4个变量,基于这些变量和FIGO分期建立5个机器学习模型,XGBoost在识别复发病例方面表现最佳,AUC为0.775。Cox回归分析显示,术前局部灌注化疗、残余病灶直径、围手术期化疗周期、手术方式是影响复发的独立危险因素,基于上述因素开发了晚期上皮性卵巢癌患者复发的预测列线图。结论:机器学习模型和列线图可早期识别卵巢癌复发,通过早期识别可改善晚期卵巢癌预后。

核糖体结合蛋白1与上皮性卵巢癌患者预后关系研究

目的研究核糖体结合蛋白1(RRBP1)在上皮性卵巢癌(EOC)中的表达及其与临床特征和预后的关系。方法本回顾性研究对106例EOC患者的肿瘤组织标本进行分析。通过qRT-PCR检测RRBP1 mRNA的表达水平,免疫组化检测RRBP1的蛋白表达情况,收集临床资料,分析RRBP1与临床病理特征和预后之间的关系。结果RRBP1在EOC中高度表达(P<0.001)。RRBP1的表达与患者肿瘤FIGO分级(P<0.001)、组织学分级(P=0.023)、组织学类型(P=0.004)和淋巴结转移(P=0.011)显著相关,但与患者年龄(P=0.391)或术前糖类抗原125水平(P=0.242)关联不显著。单变量分析显示,EOC患者的预后与患者的年龄、FIGO分级和RRBP1的表达水平有关(P<0.05)。Kaplan-Meier分析所示,RRBP1的表达水平显著影响患者的总生存期(OS,P=0.014)或无病生存期(DFS,P=0.032)。单因素生存分析发现,患者年龄、肿瘤FIGO分级也与患者预后相关(P<0.05)。多变量Cox回归分析显示,RRBP1表达水平是EOC患者OS(95%CI:1.327~4.225,P=0.009)和DFS(95%CI:1.467~3.219,P=0.007)的一个独立危险因素。结论RRBP1可以作为EOC的关键标志物,同时也有潜力成为一个潜在肿瘤治疗靶标。

年轻妇女卵巢上皮癌的临床特点及预后分析

背景与目的:卵巢上皮癌多发生于老年妇女,年轻妇女较少见。有关35岁以下妇女卵巢上皮癌的临床特点、预后因素分析报道较少。本研究旨在探讨年轻妇女卵巢上皮癌的临床特点、治疗、生存率及预后因素分析。方法:回顾性分析1980年1月至2003年12月我院收治的71例≤35岁的卵巢上皮癌患者的临床资料。生存率用寿命表法计算。利用Cox模型分析比较影响预后的因素。结果:71例确诊为卵巢上皮癌患者中位年龄28岁。临床表现为自扪及腹部包块或体检发现腹部包块18例,腹痛、腹胀各11例,肿物最大径平均为13.7cm,肿瘤位于单侧52例(73.2%),68例(95.7%)行满意细胞减灭术,手术病理分期Ⅰ期44例(62.0%)、Ⅱ期5例、Ⅲ期18例、Ⅳ期4例。病理类型以浆液性囊腺癌(40例,56.3%)和粘液性囊腺癌(22例,30.9%)为最多。病理分级为高分化42例(59.2%)、中分化18例(25.4%)、低分化11例(15.5%)。68例术前或术后进行了以铂类和紫杉醇类为基础的化疗。15例保守手术中(均为Ⅰa、G1期患者),12例无瘤生存(80.0%)。按寿命表法计算的2年生存率为86.0%,5年生存率为82.0%。Cox模型多因素分析显示病理分级、残留病灶大小是影响年轻妇女卵巢上皮癌预后的因素(P<0.05)。结论:35岁以下妇女卵巢上皮癌患者,以单侧多见,以浆液性囊腺癌多见,预后好。部分Ⅰa、G1期患者可保留生育功能。病理分级、残留病灶大小是影响35岁以下妇女卵巢上皮癌预后的因素。

卵巢上皮性癌初治患者紫杉醇加铂类与环磷酰胺加铂类方案疗效及费用的临床分析

目的:比较紫杉醇加铂类(TP组)与环磷酰胺加铂类(PC组)作为卵巢上皮性癌一线化疗方案的疗效及费用。方法:回顾性分析我院自1997年1月至2003年1月收治的符合入选标准的87例卵巢上皮性癌,其中TP方案42例,PC方案45例,比较两组在总生存率、中位生存时间、药物反应率、毒副反应、住院费用等方面的异同。结果:在早期卵巢上皮性癌(Ⅰ、Ⅱ期)中,两组生存率及无进展生存时间差异无显著性,在晚期卵巢上皮性癌(Ⅲ、Ⅳ期)中,TP组中位生存时间及中位无进展生存时间分别为41.34月及23.2月,而PC组分别为23.68月及9月,P<0.05;化疗后复发率TP组为45.24%,PC组为60%,P<0.05;消化道毒副反应发生率TP组和PC组分别为64.29%和82.22%,P<0.05;血液学副反应发生率TP组为57.14%,PC组为42.22%,P<0.05。TP组每生存1年平均住院费用为25613元人民币,PC组每生存1年平均住院费用为9108元人民币,P<0.05。结论:作为晚期卵巢上皮性癌的一线化疗方案,TP方案患者生存率提高,复发率降低,但费用增高。

FOXP1在上皮性卵巢癌中的表达及其与化疗耐药和预后的关系

目的:探讨叉头框转录蛋白1(FOXP1)在上皮性卵巢癌(EOC)中的表达及其与患者化疗耐药和预后的关系。方法:收集经手术后病理检查证实为EOC的60例患者,所有患者术后均接受以铂类为基础的规范化静脉化疗方案,采用免疫组化法测定EOC癌组织及癌旁组织FOXP1表达情况,分析FOXP1表达与EOC临床病理参数的关系;依据化疗敏感性分组,总结FOXP1表达与EOC化疗耐药的关系;并采用Kaplan-Meier法进行生存分析,并以Cox回归分析筛选EOC预后影响因素。结果:①EOC癌组织FOXP1表达阳性率明显高于癌旁组织(73.33%vs 11.67%,P<0.05);②临床分期为Ⅲ~Ⅳ期(86.67%)、病理分化程度为中、低分化(76.67%、93.75%)、伴淋巴结转移(93.33%)的EOC患者癌组织FOXP1表达阳性率显著高于临床分期为Ⅰ~Ⅱ期(33.33%)、病理分化为高分化(42.86%)且不伴淋巴结转移(66.67%)的EOC患者(P<0.05);③耐药患者癌组织FOXP1阳性率显著高于敏感患者(100.00%vs 66.67%,P<0.05);④FOXP1阴性EOC患者累积生存时间显著高于FOXP1阳性患者(35.05月vs 29.06月,P<0.05);⑤FOXP1表达、临床分期、病理分化程度、淋巴结转移、化疗敏感程度均为EOC预后的影响因素(P<0.05)。结论:EOC癌组织FOXP1呈异常高表达,且FOXP1与EOC分化程度、临床分期、肿瘤转移密切相关,FOXP1可能为预测EOC化疗耐药及不良预后的分子标志物。

保留生育功能手术在上皮性卵巢癌治疗中的系统评价

目的:采用循证医学Meta分析的方法评价保留生育功能手术与根治性手术对治疗上皮性卵巢癌患者生存率的影响,并且系统评价保留生育功能手术治疗上皮性卵巢癌的生存率、复发率和术后妊娠情况。方法:计算机检索Cochrane Library、Pubmed、Embase、MEDLINE、CBMdise、维普等数据库,检索年限从建库至2013年7月,并追查了所有纳入文献的参考文献。手工检索相关杂志、会议论文集、学位论文汇编等。采用STATA 10.0软件进行Meta分析。并对非临床对照研究资料进行分析。结果:共纳入8个保留生育功能手术和根治性手术治疗上皮性卵巢癌生存率比较的临床对照实验和11个无对照的临床研究。Meta分析结果表明,保留生育功能手术和根治性手术治疗上皮性卵巢癌的生存率差异无统计学意义(OR:0.88,95%CI=0.52~1.51,P=0.64)。根据11篇分析保留生育功能手术的临床研究文献计算出的生存率为97%,复发率为11%,其中9篇临床病例研究详细记录和分析了有生育要求并尝试怀孕和实际成功受孕的例数并计算出总的妊娠率为67%。结论:保留生育手术不会降低年轻的早期上皮性卵巢癌患者的生存期且能维持正常的妊娠和生育功能,提高了患者生存质量。

联合VEGF和MMP-9检测探寻临床完全缓解上皮性卵巢癌患者的CA125界值

目的联合血清VEGF和MMP-9检测探寻临床完全缓解上皮性卵巢癌患者的CA125界值.方法采集临床完全缓解上皮性卵巢癌患者静脉血,测定各组患者血清CA125,VEGF和MMP-9水平,并对患者进行病情监测和随访.结果以17 U/mL作为CA125分割值,将临床完全缓解上皮性卵巢癌患者分为两组,C1(CA125≤17 U/mL)组2a无瘤生存率较C2(17 U/mL<CA125<35 U/mL)组明显升高,C1组患者血清VEGF,MMP-9水平较C2组明显降低.结论将17 U/mL作为上皮性卵巢癌患者终止治疗的CA125界值,更有利于消灭隐匿病灶,改善上皮性卵巢癌患者的治疗结局.

52例老年上皮性卵巢癌病人的临床特点及预后相关因素分析

目的探讨老年上皮性卵巢癌病人的预后相关因素及5年生存率。方法回顾性分析2010~2012年于我院初治的52例上皮性卵巢癌老年病人的临床资料,采用卡方检验进行单因素分析,采用Cox比例风险模型进行多因素分析。结果 52例老年病人的总体5年生存率为42.31%,Ⅰ~Ⅱ期病人的5年生存率明显高于Ⅲ~Ⅳ期病人(P<0.05),分别为84.21%、18.18%;手术残留灶<1 cm的病人5年生存率显著高于残留灶≥1 cm的病人(P<0.05),分别为56.76%、6.67%;化疗疗程≥6个周期的病人5年生存率明显高于化疗疗程<6个周期的病人(P<0.05),分别为50.00%、46.30%。多因素分析结果显示手术分期是老年卵巢癌病人预后的独立影响因素。结论手术分期、残留灶大小、化疗疗程等可影响病人预后,其中手术病理分期是老年上皮性卵巢癌预后的独立影响因素。

CA125在上皮性卵巢癌中的表达及其与预后的相关性分析

目的探讨CA125在上皮性卵巢癌中的表达及其与预后的相关性。方法回顾性分析247例确诊为上皮性卵巢癌患者的临床资料,所有患者至少随访5年或随访至死亡。采用化学发光免疫法检测CA125,并划分为q1、q2、q3和q4共4个区间。比较CA125在不同临床病理特征患者中的表达差异,比较4个区间的生存情况。采用Logistic回归分析预后因素。结果 CA125在年龄、病理类型、FIGO分期、组织学分化和术后残留病灶大小不同的病例中的表达均具有统计学意义（P〈0.05）。q1、q2、q3和q4区间的中位生存期分别为58、40、19和11个月,5年生存率分别为48.4%（30/62）、32.3%（20/62）、21.0%（13/62）和11.5%（7/61）,差异均具有统计学意义（P〈0.05）。Logistic回归分析显示,与q1比较,q2、q3和q4预后死亡的OR（95%CI）分别为1.624（1.445~1.825）、2.447（1.785~3.355）和4.121（2.624~6.472）。结论 CA125表达与上皮性卵巢癌不同临床病理特征具有相关性,术前CA125可作为上皮性卵巢癌预后的独立预测因子。