Ma Xuegong, Wang Yingmei, Sheng Hongna, Tian Wenyan, Qi Zheng, Teng Fei, Xue Fengxia
Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China.
J Obstet Gynaecol Res. 2014 Jan;40(1):178-83. doi: 10.1111/jog.12151. Epub 2013 Sep 19.
The aim of this study is to investigate the impact of preoperative platelet counts, parameters and aggregation rates (maximal aggregation rate: MAR) on prognosis in patients with epithelial ovarian cancer (EOC).
Preoperative platelet count, parameters and MAR in 182 EOC patients, 122 patients with benign ovarian tumor and 150 healthy women were retrospectively analyzed. The correlation between thrombocytosis, platelet parameters, MAR and clinicopathological factors were evaluated in EOC.
Forty-five (24.73%) EOC patients had preoperative thrombocytosis in this study. The mean platelet count in the EOC group was significantly higher than that of benign and healthy groups (P < 0.001). The MAR in the EOC group was significantly higher than that in the healthy group (71.96% vs 57.03%, P = 0.025). The platelet parameters (mean platelet volume, platelet distribution width, thrombocytocrit and large platelet ratio) were consistently higher in the EOC group than those in the benign and healthy groups, but the differences were insignificant. A significant correlation between thrombocytosis and MAR was observed in EOC patients (r = 0.694, P < 0.001). EOC patients with thrombocytosis were found to have significantly higher grade (P = 0.048), more advanced stage (P = 0.045), higher level carbohydrate antigen-125 (P = 0.007) and greater likelihood of suboptimal cytoreduction (P = 0.035). EOC patients with both thrombocytosis and high MAR were found to have shorter progression-free survival (P = 0.001)and overall survival (P = 0.004). The combination of thrombocytosis and MAR, as well as stage and optimal cytoreduction, retained significance as an independent prognostic factor for overall survival.
Thrombocytosis, accompanied by increasing of platelet aggregation rates, is associated with more aggressive tumor biology in EOC. The combination of thrombocytosis and MAR is an independent negative prognostic factor for overall survival in EOC patients.
本研究旨在探讨术前血小板计数、参数及聚集率（最大聚集率：MAR）对上皮性卵巢癌（EOC）患者预后的影响。
回顾性分析182例EOC患者、122例卵巢良性肿瘤患者及150例健康女性的术前血小板计数、参数及MAR。评估EOC患者中血小板增多症、血小板参数、MAR与临床病理因素之间的相关性。
本研究中45例（24.73%）EOC患者术前存在血小板增多症。EOC组的平均血小板计数显著高于良性组和健康组（P < 0.001）。EOC组的MAR显著高于健康组（71.96%对57.03%，P = 0.025）。EOC组的血小板参数（平均血小板体积、血小板分布宽度、血小板压积和大血小板比率）始终高于良性组和健康组，但差异无统计学意义。EOC患者中观察到血小板增多症与MAR之间存在显著相关性（r = 0.694，P < 0.001）。发现血小板增多症的EOC患者分级显著更高（P = 0.048）、分期更晚（P = 0.045）、糖类抗原125水平更高（P = 0.007）且肿瘤细胞减灭术不理想的可能性更大（P = 0.035）。发现同时存在血小板增多症和高MAR的EOC患者无进展生存期（P = 0.001）和总生存期（P = 0.004）更短。血小板增多症与MAR的联合，以及分期和理想的肿瘤细胞减灭术，作为总生存期的独立预后因素仍具有显著性。
血小板增多症，伴随着血小板聚集率的增加，与EOC中更具侵袭性的肿瘤生物学行为相关。血小板增多症与MAR的联合是EOC患者总生存期的独立不良预后因素。
