晚期卵巢癌预后相关因素分析

目的:探讨血糖、临床病理特征与晚期卵巢癌预后的关系。方法:回顾分析天津市中心妇产科医院2003年1月～2008年12月收治并随访到的159例Ⅲ、Ⅳ期上皮性卵巢癌患者的临床资料。采用Kaplan-Meier法分析生存时间,单因素分析各变量与预后的关系用log-rank检验,多因素分析用Cox风险比例回归模型。结果:25例血糖≥6.10mmol/L患者3年(47.96%)及5年(32.57%)生存率低于血糖6.10mmol/L者(P0.05)。Ⅲc期卵巢癌患者的3、5年生存率分别为54.36%和34.51%,Ⅳ期患者的3、5年生存率分别为32.49%和15.92%(P0.05)。组织学分化为G2和G3者3、5年生存率分别为45.89%和31.79%,低于G1者(P0.05)。残余肿瘤直径2cm患者3、5年生存率分别为39.12%和26.76%,低于残余肿瘤直径≤2cm者(P0.05)。浆液性、黏液性、子宫内膜样、未分类4组病理类型患者的远期生存率差异无统计学意义(P0.05)。Cox风险比例回归模型进行多因素分析,血糖高低相对危险度(RR)为2.008,95%置信区间(CI)为1.179～4.018,P=0.034]、手术病理分期(RR=2.391,95%CI为1.345～4.198,P=0.024),组织学分化(RR=2.363,95%CI为1.351～4.193,P=0.032)及残余肿瘤大小(RR=3.564,95%CI为2.683～6.857,P=0.01)是卵巢癌的预后因素。结论:血糖、手术病理分期、组织学分化、残余肿瘤直径可以作为卵巢癌的预后因素。

Analysis of prognostic factors in advanced ovarian cancer

Objective:To analyze the relationship between blood glucose and clinico-pathological features and the prognosis of patients with advanced epithelial ovarian cancer.Methods:A retrospective analysis was conducted on 159 patients with stage Ⅲ,Ⅳ ovarian cancer from January 2003 to December 2008.Chi-square test,survival analysis,univariate and COX proportional hazard analysis were used to identify prognostic factors for patients with advanced epithelial ovarian cancer.Results:The 3-year overal survial(OS) and 5-year OS in 25 patients with blood glucose ≥6.10mmol/L were 47.96% and 32.57% respectively,which were lower than that of patients with blood glucose <6.10mmol/L.The 3-year OS and 5-year OS in patients with G2/G3 tumor were 45.89% and 31.78% respectively,which were significantly lower than that of patients with G1 tumor.No significant differences were observed in OS between pathological subtypes,including serous,mucinous,endometrioid and others,respectively(P>0.05).Multivariate COX proportional hazard model analysis indicated that blood glucose,stage,tumor grade,and residual tumor size were independently associated with the survival rate in patients with advanced epithelial ovarian cancer.Conclusions:Blood glucose,stage,tumor grade and residual tumor size were prognostic factors of patients with andvanced epithelial ovarian cancer.