卵巢上皮性癌的预后影响因素分析

目的 探讨卵巢上皮性癌(卵巢癌)的预后影响因素.方法 回顾性分析2002年1月至2005年12月在山西省肿瘤医院初诊的卵巢癌患者的临床病理资料.结果年龄、分期、病理类型、病理分化程度、术后残余瘤的大小以及术后化疗疗程数是卵巢癌的预后因素(P<0.01).以Ⅳ期患者的死亡风险为1,则Ⅰ期、Ⅱ期、Ⅲ期患者的死亡风险分别为0.005、0.106、0.361,95% CI分别为0.001～0.024、0.038～0.297、0.181～0.718(P<0.01);以术后残余瘤直径>2 cm患者的死亡风险为1,则残余瘤直径≤2 cm患者的死亡风险仅为0.307,95% CI为0.176～0.536(P<0.01);术后化疗疗程数<6个疗程患者的死亡风险为≥6个疗程者的8.191倍,95% CI为4.666～14.379(P<0.01).是否有恶性肿瘤家族史对卵巢癌预后无影响(P>0.05).结论 分期、术后残余瘤的大小、术后化疗的疗程数是卵巢痛的独立预后影响因素.尽力做到早诊断、早治疗,术后辅以正规、足疗程的化疗是提高卵巢癌生存率的关键.

Analysis of prognostic factors of epithelial ovarian carcinoma

Objective To assess prognostic factors impacted on overall survival in patients with epithelial ovarian carcinoma. Methods Totally 170 patients with stages Ⅰ-Ⅳ epithelial ovarian carcinoma admitted in Shanxi Provincial Cancer Hospital from Jan 2002 to Dec 2005 were analyzed by retrospective analysis. Results The results showed that the prognostic factors of epithelial ovarian carcinomas were related to age, stage, histological type, pathological differential grade, the size of residues lesions and the number of course of chemotherapy (P<0.01). The univariate analysis showed that family history was not related to the survival of epithelial ovarian carcinoma (P > 0.05). Compared with stage Ⅳ,the risk of mortality was 0.005 for stage Ⅰ (95% CI, 0.001-0.024), 0.106 for stage Ⅱ (95% CI,0.038-0.297) and0.361 (95% CI, 0.181-0.718)for stage Ⅲ (P<0.01). The risk of mortality was 0.307 (95% CI, 0.176-0.536) for the patients with residual diameter >2 cm, in comparison with the residual ≤2 cm (P < 0.01). The risk of mortality in patients received < 6 courses of chemotherapy was 8.191 times higher than that in patients received ≥6 courses of chemotherapy (95% CI, 4. 666-14. 379;P < 0.01). Conclusions The major independent prognostic variables for epithelial ovarian carcinoma are stage, the size of residual tumor lesions and the number of courses of chemotherapy. Therefore, the earlier diagnosis, the earlier surgery, sufficient cycles and timely assistant chemotherapy are the key point to improve the survival rates of epithelial ovarian carcinoma.