Bozkurt Nuray, Yuce Kunter, Basaran Mustafa, Kose Faruk, Ayhan Ali
Gazi University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
Obstet Gynecol. 2004 Jan;103(1):82-5. doi: 10.1097/01.AOG.0000102703.21556.0B.
To evaluate the significance of preoperative platelet counts in advanced epithelial ovarian cancer with respect to second-look laparotomy results and disease progression.
We prospectively evaluated 37 consecutive patients with advanced epithelial ovarian cancer who underwent primary surgical treatment. In addition to platelet counts, all patients were evaluated with respect to age, gravida, parity, and stage and grade of tumor. Thirty-six patients had stage III, and 1 patient had stage IV disease. Optimal debulking (diameter of residual tumor, less than 1 cm) was performed in all patients who subsequently received adjuvant chemotherapy (platin-paclitaxel). According to second-look laparotomy and follow-up results patients were divided into 2 groups. The first group had negative second-look laparotomy or no evidence of disease during follow-up (n = 20), and the second group had positive second-look laparotomy or progressive disease (n = 17). Sensitivity and specificity values were calculated for different cutoff values of platelet counts with receiver operating characteristic curve analysis.
Age, gravida, and parity were not significantly different compared with controls (P >.05). Mean platelet counts were 371 x 109/L and 446 x 109/L in the first and second groups, respectively (P =.03). Different cutoff values of platelet counts for the diagnosis of thrombocytosis were evaluated. A cutoff value of 380 x 109/L had sensitivity 77% and specificity 60% for recurrence, whereas a cutoff value of 400 x 109/L had sensitivity 59% and specificity 65%. Area under the curve (+/- standard error) was 0.72 +/- 0.08 (P =.026).
In patients with progressive disease and positive second-look laparotomy, preoperative platelet counts were significantly higher compared with patients with no evidence of disease on follow-up.
评估晚期上皮性卵巢癌术前血小板计数对于二次探查剖腹术结果及疾病进展的意义。
我们前瞻性评估了37例连续接受初次手术治疗的晚期上皮性卵巢癌患者。除血小板计数外，还对所有患者的年龄、孕次、产次以及肿瘤的分期和分级进行了评估。36例患者为Ⅲ期，1例患者为Ⅳ期疾病。所有随后接受辅助化疗（铂类-紫杉醇）的患者均进行了最佳肿瘤细胞减灭术（残留肿瘤直径小于1 cm）。根据二次探查剖腹术及随访结果，将患者分为两组。第一组二次探查剖腹术结果为阴性或随访期间无疾病证据（n = 20），第二组二次探查剖腹术结果为阳性或疾病进展（n = 17）。通过绘制受试者工作特征曲线分析，计算不同血小板计数临界值的敏感度和特异度。
与对照组相比，年龄、孕次和产次无显著差异（P >.05）。第一组和第二组的平均血小板计数分别为371×10⁹/L和446×10⁹/L（P =.03）。评估了诊断血小板增多症的不同血小板计数临界值。血小板计数临界值为380×10⁹/L时，复发的敏感度为77%，特异度为60%；临界值为400×10⁹/L时，敏感度为59%，特异度为65%。曲线下面积（±标准误）为0.72±0.08（P =.026）。
在疾病进展且二次探查剖腹术结果为阳性的患者中，术前血小板计数显著高于随访期间无疾病证据的患者。
