年轻妇女卵巢上皮细胞癌预后因素分析

目的　探讨年轻妇女卵巢上皮细胞癌的临床特点、生存率和影响预后的因素。方法回顾分析 1985～ 1997年收治的 4 5 5例卵巢上皮细胞癌患者的临床资料。生存率采用Kaplan Meier方法计算 ,利用Cox风险比例回归模型分析比较影响患者预后的独立因素。结果　≤ 4 0岁组92例 ,>4 0岁 36 3例。≤ 4 0岁组早期、高分化、黏液性癌所占比例明显高于 >4 0岁组 ,浆液性癌、腹水、肿瘤残存所占比例低于 >4 0岁患者 ,差异均有显著性 (P <0 .0 5 )。≤ 4 0岁组和 >4 0岁组的 5年生存率分别为 79.5 %和 2 8.2 % ,差异均有极显著性 (P <0 .0 0 1)。单因素分析两组间同一临床分期、组织类型、分级、肿瘤残存情况等显示 ,在相同情况下 ,≤ 4 0岁患者的生存率明显高于 >4 0岁者。多因素分析显示 ,临床分期、肿瘤残存情况和年龄为影响预后的独立因素。结论　≤ 4 0岁的卵巢上皮细胞癌患者 ,其早期、Ⅰ级、黏液性囊腺癌所占比例高 ,肿瘤残存小 ,腹水少 ,总的 5年生存率高。临床分期、肿瘤残存情况、年龄是影响卵巢上皮细胞癌预后的独立因素。

Prognostic factors of epithelial ovarian cancer in young women

OBJECTIVE: To evaluate the clinical characteristics, survival rate and prognosis of young patients with epithelial ovarian carcinoma. METHODS: The clinic data of 455 women with epithelial ovarian carcinoma were reviewed. Kaplan-Meier method was used to calculate the survival rate. Cox proportional hazards regression model was used to determine the independent effect of each variable on survival. RESULTS: Of 445 patients with epithelial ovarian carcinoma, 92 were < or = 40 years of age and 363 were older. Higher incidence of early-stage, well differentiation and mucous cell type but lower incidence of serous cell type, ascites and residual tumors were found in the younger group. The overall 5-year survival rates were 79.55% in < or = 40 years group and 28.2% in > 40 years group (P < 0.001). Univariate analysis showed that the survival rate of patients < or = 40 years was significantly higher than that of > 40 years. Only age, stage and residual disease were found to be the significant independent prognostic factors by the multivariate analysis. CONCLUSION: Epithelial ovarian carcinoma in patients with age