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子宫内膜异位症相关卵巢癌化疗耐药危险因素的临床分析。

Clinical analysis of chemo-resistance risk factors in endometriosis associated ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 1 ShuaiFuYuan, DongCheng District, Beijing, 100730, China.

Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

J Ovarian Res. 2018 May 29;11(1):40. doi: 10.1186/s13048-018-0418-8.

Abstract

BACKGROUND

To analyze the clinical characteristics and chemo-resistance related factors of patients with resistant and non-resistant endometriosis-associated ovarian cancer (ovarian clear cell carcinoma and endometrioid carcinoma) by reviewing the data of epithelial ovarian cancer patients who received initial treatment in our hospital over a 12-year period.

RESULTS

Among the 304 patients, 17.1% were seen with platinum-based drug resistance. The ROC curve of continuous variables was drawn according to resistance situation, then they were grouped by age (< 48 or ≥ 48 years), tumor size (< 7 cm or ≥ 7 cm) and Ca125 (< 90 and ≥ 90 U/ml). In univariate analysis, age ≥ 48 years, initial symptom of abdominal distension or weight loss, abnormal preoperative serum Ca125, Ca125 < 90 U/ml, advanced FIGO stage, absence of endometriosis, bilateral tumors, lack of lymphadenectomy, positive lymph nodes, unsatisfactory initial cytoreduction surgery and history of breast cancer were all related to drug resistance in ovarian cancer. In multivariate analysis, advanced stage, lack of lymphadenectomy, positive lymph nodes and history of breast cancer were independent risk factors related to platinum-based drug resistance (P < 0.05).

CONCLUSION

For patients of endometriosis-related ovarian cancer, platinum-based drug resistance were associated with advanced FIGO stage, lack of lymphadenectomy, positive lymph nodes and history of breast cancer.

摘要

背景

通过回顾我院近 12 年来收治的上皮性卵巢癌患者的资料,分析耐药性和非耐药性子宫内膜异位症相关卵巢癌(卵巢透明细胞癌和子宫内膜样癌)患者的临床特征及化疗耐药相关因素。

结果

304 例患者中,有 17.1%的患者出现铂类药物耐药。根据耐药情况绘制连续变量的 ROC 曲线,然后按年龄(<48 岁或≥48 岁)、肿瘤大小(<7cm 或≥7cm)和 Ca125(<90 和≥90U/ml)分组。单因素分析显示,年龄≥48 岁、首发症状为腹胀或体重减轻、术前血清 Ca125 异常、Ca125<90U/ml、FIGO 分期较晚、无子宫内膜异位症、双侧肿瘤、无淋巴结切除术、淋巴结阳性、初次肿瘤细胞减灭术不彻底和有乳腺癌病史与卵巢癌耐药有关。多因素分析显示,晚期、无淋巴结切除术、淋巴结阳性和乳腺癌病史是与铂类药物耐药相关的独立危险因素(P<0.05)。

结论

对于子宫内膜异位症相关卵巢癌患者,铂类药物耐药与 FIGO 分期较晚、无淋巴结切除术、淋巴结阳性和乳腺癌病史有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c569/5975270/21093e1745b4/13048_2018_418_Fig1_HTML.jpg

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