Ayhan A, Gultekin M, Taskiran C, Dursun P, Firat P, Bozdag G, Celik N Y, Yuce K
Departments of Obstetrics and Gynecology and Pathology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
Int J Gynecol Cancer. 2007 Jan-Feb;17(1):68-75. doi: 10.1111/j.1525-1438.2006.00777.x.
Ascites is a common finding in patients with epithelial ovarian cancer (EOC). Clinico-pathologic correlations with respect to the presence of ascites, positive cytology and prognostic role of ascites, and the impact of ascitic volumes were not previously studied extensively. A total of 372 patients with EOC were retrospectively evaluated with respect to presence and amount of ascites, cytologic findings, and survival. Two groups were compared by using Chi-square, Student's t and Mann-Whitney U, binary logistic regression, Kaplan Meier and Cox-regression analysis tests, where appropriate. Omental metastasis (P < 0.001; OR: 3.21, 95% CI = 1.945-5.297) and mean number of metastatic lymph nodes (P= 0.008; OR: 1.063, 95% CI = 1.016-1.112) were significantly related with presence of ascites. Evaluation of ascitic volume at different thresholds revealed lymphatic-omental metastasis, and also the disease stage to be significantly different among patient groups at lower threshold values and the positive cytology and high-grade diseases at higher threshold values. In conclusion, presence of ascites correlates with both the intraperitoneal and also the retroperitoneal tumor spread. Amount of ascites has different correlations with the clinico-pathologic factors depending on the thresholds chosen. At lower volumes, lymphatic and omental metastasis seems to correlate with the development of ascites. Once ascites develops, tumor grade seems to be important for larger ascites volumes. Neither the presence of ascites or its volume nor the cytologic positivity was an independent predictor of survival.
腹水是上皮性卵巢癌（EOC）患者的常见表现。此前尚未广泛研究腹水的存在、阳性细胞学结果及腹水的预后作用，以及腹水量的影响与临床病理之间的相关性。对372例EOC患者的腹水存在情况、腹水量、细胞学检查结果及生存率进行了回顾性评估。在适当情况下，采用卡方检验、学生t检验、曼-惠特尼U检验、二元逻辑回归、Kaplan-Meier检验和Cox回归分析对两组进行比较。大网膜转移（P < 0.001；OR：3.21，95%CI = 1.945 - 5.297）和转移淋巴结的平均数量（P = 0.008；OR：1.063，95%CI = 1.016 - 1.112）与腹水的存在显著相关。对不同阈值下的腹水量进行评估发现，在较低阈值时，患者组间的淋巴管-大网膜转移及疾病分期存在显著差异，在较高阈值时，阳性细胞学结果及高级别疾病存在显著差异。总之，腹水的存在与腹膜内及腹膜后肿瘤扩散均相关。根据所选阈值不同，腹水量与临床病理因素有不同的相关性。腹水量较低时，淋巴管和大网膜转移似乎与腹水的形成相关。一旦腹水形成，肿瘤分级对于较大腹水量似乎很重要。腹水的存在与否、腹水量及细胞学阳性结果均不是生存的独立预测因素。
