上皮性卵巢癌初次肿瘤细胞减灭术后复发情况及影响因素分析

目的:研究上皮性卵巢癌初次肿瘤细胞减灭术后复发情况以及影响因素分析，旨在为降低上皮性卵巢癌初次肿瘤细胞减灭术后复发提高患者术后生存质量提供有效的理论依据。方法:采用回顾性方法分析我院在2008年1月至2012年12月期间进行肿瘤细胞减灭术治疗的186例上皮性卵巢癌患者的临床资料，术后根据患者复发情况将患者分成复发组与未复发组。观察两组患者年龄、组织学类型、化疗方式、新辅助化疗、临床分期、组织分级、残余病灶、腹水、术前HE4、术后2月CA125、淋巴结切除之间的差异，同时分析影响上皮性卵巢癌初次肿瘤细胞减灭术后复发的独立危险因素。结果:随访5年，复发患者有78例，复发率为41.94%，未复发患者108例；复发组与未复发组患者在年龄、组织学类型、化疗方式、新辅助化疗等因素中比较无差异（P＞0.05），在临床分期、组织分级、残余病灶、腹水、术前HE4、术后2月CA125、淋巴结切除中存在明显差异（P＜0.05）；经Logistic回顾分析证明，临床分期、残余病灶、腹水、术前HE4、淋巴结切除是临床上皮性卵巢癌患者初次肿瘤细胞减灭术后复发的独立危险因素［OR=9.786（3.484~27.493）、OR=8.199（4.431 ~15.172）、OR=9.143（3.975~21.031）、OR=9.337（4.593~18.983）、OR=11.917（6.440~22.053）］。结论:上皮性卵巢癌患者经初次肿瘤细胞减灭术治疗后，复发率为41.94%左右，而影响患者术后复发的独立危险因素为临床分期、残余病灶、腹水、术前HE4、淋巴结切除等，临床上可针对这些因素进行干预降低临床术后复发率，提高患者生活质量。

Analysis of postoperative recurrence and influencing factors of epithelial ovarian cancer patients with initial cytoreductive surgery

Objective:To investigate the postoperative recurrence and influencing factors of epithelial ovarian cancer patients with initial cytoreductive surgery,and to provide an effective theoretical basis for reducing the recurrence of epithelial ovarian cancer patients with initial cytoreductive surgery and improving the patients' quality of life after operation.Methods:The clinical data of 186 patients with epithelial ovarian cancer treated by cytoreductive surgery from January 2008 to December 2012 were retrospectively analyzed.The patients were divided into recurrent group and non recurrent group according to the recurrence of the patients.The difference of the two groups were observed,including age,histological type,chemotherapy methods,neoadjuvant chemotherapy,clinical staging,histological grading,residual lesions,ascites,preoperative HE4,postoperative CA125 and lymph node resection.Independent risk factors for recurrence of epithelial ovarian cancer patients with initial cytoreductive surgery were analyzed.Results:There were 78 cases of recurrent disease,the recurrence rate was 41.94%,and 108 cases were not recurrence in the postoperative 5 years follow-up.There was no significant difference in age,histological type,chemotherapy,neoadjuvant chemotherapy and other factors between the recurrent group and the non recurrence group (P＞0.05),but the clinical staging,histological grading,residual lesions,ascites,preoperative HE4,postoperative CA125 and lymph node resection between the two groups showed a significant difference (P＜0.05).Logistic regression analysis showed that clinical staging,residual lesions,ascites,preoperative HE4 and lymph node dissection were the independent risk factors of recurrence after initial cytoreductive surgery in patients with epithelial ovarian cancer ［OR=9.786(3.484~27.493,OR=8.199(4.431~15.172),OR=9.143(3.975~21.031),OR=9.337(4.593~18.983),OR=11.917(6.440~22.053)］.Conclusion:According to the results of this study,the recurrence rate of epithelial ovarian cancer patients after initial cytoreductive surgery was about 41.94%,and the independent risk factors of postoperative recurrence were clinical stage,residual lesions,ascites,preoperative HE4,Lymph node resection.Clinical intervention can be carried out according to these factors to reduce the recurrence rate and improve the quality of life.