卵巢上皮癌的预后影响因素分析

目的:探讨卵巢上皮癌预后的影响因素.方法:回顾分析自2005年1月至2010年12月在陕西省肿瘤医院收治的292例卵巢上皮癌患者的临床资料.采用Kaplan-Meier法分析生存时间,应用Log-rank法进行组别间生存率差异检验,采用OR值对各因素间进行危险度分析.结果:年龄、手术分期、组织学类型、病理分化程度、肿瘤细胞减灭术后残余瘤的大小以及术后化疗疗程数是卵巢上皮癌的预后生存指标.以FIGOⅠ期患者的死亡风险为1,则Ⅱ期、Ⅲ期、Ⅴ期的死亡风险分别为Ⅰ期的3倍、14.7倍、21.8倍；以术后残余瘤直径≤2cm患者的死亡风险为l,则残余瘤直径＞2cm的患者的死亡风险为残余瘤直径≤2cm患者的死亡风险的80.7倍；化疗疗程数＜6疗程的死亡风险为≥6疗程的2.3倍.以高分化患者的死亡风险为l,则中、低分化的死亡风险分别为高分化的2.4倍、3.8倍.结论:FIGO分期,首次肿瘤细胞减灭术后残余瘤的大小、化疗疗程数、病理分化程度是卵巢上皮癌的独立预后因素.因此尽力做到早诊断、早治疗,术后辅以正规、足程的化疗是提高卵巢上皮癌生存率的关键.

Prognostic factors of epithelial ovarian carcinoma

Objective:To assess prognostic factors in patients with epithelial ovarian carcinoma.Methods: Total of 292 patients with stages I-IV epithelial ovarian carcinoma in Shaanxi Provincial Cancer Hospital from January 2005 to December 2010 were analyzed by retrospective analysis.Results: The prognostic factors of epithelial ovarian carcinomas were age,FIGO stage,histologic type,pathological differential grade,size of residues and number of chemotherapy treatment course.The risk of mortality according to FIGO stage was 3 for FIGO II,14.7 for FIGO III,21.8 for FIGO IV;in comparison with FIGO I.The risk of mortality according to the size of residues was 80.7 for the remaining lump diameter≤2cm,in comparison with the remaining lump diameter>2cm.Patients with <6 courses of chemotherapy had 2.3 times higher risk of mortality than patients with ≥6 courses of chemotherapy.Conclusion: FIGO stage,the size of residual tumor after primary operation,the number of courses of chemotherapy and pathological differential grade are the major independent prognostic factors of epithelial ovarian carcinoma.Therefore,improving the earlier diagnosis to give the earlier treatment are the key points to improve the survival rates of epithelial ovarian carcinoma.Regular,sufficient cycles and timely assistant chemotherapy are the necessary measures to improve the survival rates of epithelial ovarian carcinoma.