Qu Yanjun, He Yanan, Li Zhangming, Chen Xiuwei, Liu Qian, Zou Shuangshuang, Kong Congcong, Liu Yixiu, Gao Ce, Zhang Guangmei, Zhu Wenliang
Department of Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Pharmacy, Guangdong Hospital of Integrated Chinese and Western Medicine, Foshan, China.
Oncotarget. 2017 Nov 6;8(60):102212-102222. doi: 10.18632/oncotarget.22336. eCollection 2017 Nov 24.
Globally, ovarian cancer (OC) is the leading cause of gynecological cancer-associated deaths. Metastasis, especially multi-organ metastasis, determines the speed of disease progression. A multicenter retrospective study was performed to identify the factors that drive metastasis, from medical records of 534 patients with OC. The average number of target organs per patient was 3.66, indicating multi-organ metastasis. The most common sites of metastasis were large intestine and greater omentum, which were prone to co-metastasis. Results indicated that ascites and laterality, rather than age and menopausal status, were the potential drivers for multi-organ metastasis. Cancer antigen (CA) 125 (CA-125) and nine other blood indicators were found to show a significant, but weak correlation with multi-organ metastasis. A neural network cascade-multiple linear regression hybrid model was built to create an ovarian cancer metastasis index (OCMI) by integration of six multi-organ metastasis drivers including CA-125, blood platelet count, lymphocytes percentage, prealbumin, ascites, and laterality. In an independent set of 267 OC medical records, OCMI showed a moderate correlation with multi-organ metastasis (Spearman ρ = 0.67), the value being 0.72 in premenopausal patients, and good performance in identifying multi-organ metastasis (area under the receiver operating characteristic curve = 0.832), implying a potential prognostic marker for OC.
在全球范围内，卵巢癌（OC）是妇科癌症相关死亡的主要原因。转移，尤其是多器官转移，决定了疾病进展的速度。我们进行了一项多中心回顾性研究，从534例OC患者的病历中确定驱动转移的因素。每位患者的平均靶器官数量为3.66个，表明存在多器官转移。最常见的转移部位是大肠和大网膜，它们容易发生共同转移。结果表明，腹水和肿瘤侧别而非年龄和绝经状态是多器官转移的潜在驱动因素。发现癌抗原（CA）125（CA-125）和其他九种血液指标与多器官转移呈显著但较弱的相关性。通过整合包括CA-125、血小板计数、淋巴细胞百分比、前白蛋白、腹水和肿瘤侧别在内的六个多器官转移驱动因素，构建了一个神经网络级联-多元线性回归混合模型，以创建卵巢癌转移指数（OCMI）。在一组独立的267份OC病历中，OCMI与多器官转移呈中度相关（Spearman ρ = 0.67），绝经前患者的值为0.72，在识别多器官转移方面表现良好（受试者工作特征曲线下面积 = 0.832），这意味着它可能是OC的一个潜在预后标志物。
