| Objective:To explore the relationship between multiple clinical factors and the prognosis of advanced epithelial ovarian cancer,to identify the factors that affect platinum resistance in epithelial ovarian cancer,and to provide a reference for judging the prognosis of patients with advanced ovarian cancer and developing a clinical treatment plan..Methods:From January 2010 to April 2017,160 patients with advanced epithelial ovarian cancer were enrolled at the Bethune First Hospital of Jilin University.160 patients were divided into two groups according to the length of recurrence,of which 92were platinum-sensitive group and 68 were platinum-resistant group.Retrospective analysis of the two groups in terms of age,stage,tumor size,CA125 value,platelet count,etc.Differences,analysis of platinum-resistant factors.In addition,160patients were divided into two groups according to different treatment methods.Among them,63 were NACT-IDS group and 97 were PDS group.The differences in age,FIGO stage,histological type,histological grade,etc.were compared between the two groups,and the effects of the two methods on platinum resistance and overall survival were explored.Statistical Methods:All data were processed using SPSS 17.0 statistical software.Measured data were expressed as(±s),t-tests were used for comparison between groups,X~2 test was used for single factor analysis of platinum-resistance effects,Logistic regression analysis was used for multiple factors,and Kaplan-Meier curves were used for survival analysis.P<0.05 indicates that the difference was statistically significant.Results:1、Of the 160 patients,92 were platinum-sensitive,accounting for 57.5%,and platinum-resistant were 68,accounting for 42.5%.2、In the univariate analysis of platinum resistance relapsein patients with advanced ovarian cancer recurrence,the results showed that:1:The rate of drug resistance relapse(72.8%)in the FIGO stage was significantly higher than that in the stage III group(37.7%).The recurrence rate of drug resistance in the high-grade group of histological grade(33.8%)was significantly lower than that of other groups(50%).The relapse rate of drug resistance in the>300×109/L(53.3%)group was significantly higher than that in the platelet count≤300×109/L group(27.9%),and the relapse rate of drug resistance in the residual lesion size≤1cm group was significantly higher.(33.8%)was significantly lower than the relapse rate of drug resistance in the>1 cm group(51.3%).Ascites exfoliated cells detected a relapse rate of drug resistance in the cancer cell group(46.8%)was significantly higher than the relapse rate of drug resistance in the no cancer cell group(27.8%).The rate of relapse resistance in the after two chemotherapy CA125-positive group(ie higher than the normal value group)after chemotherapy(68.1%)was significantly higher than that in the negative group(ie within the normal range)(23.1%).The above comparison P<0.05,the difference was statistically significant.2:Age(≤50 years old and>50 groups),pathological type(serous and non-serous group),chemotherapy(intravenous chemotherapy alone,intravenous chemotherapy+intraperitoneal chemotherapy group),initial tumor size(≤10cm and>10cm Group),pleural effusion(without group),ascites volume(≤1000ml and>1000ml group),maximal metastasis(≤1cm and>1cm group),baseline CA125(≤1000U/ml and>1000U/ml group),treatment There was no significant difference in the rates of relapse resistance among the groups(NACT-IDS and PDS groups)in each group.3、In a multivariate analysis of factors that affected the recurrence of advanced ovarian cancer,the results were:FIGO stage(Exp(B)=0.406,P=0.032),platelet count(Exp(B)=2.509,P=0.013),and CA125 after two chemotherapy.The negative condition(Exp(B)=2.216,P=0.047)was statistically significant.Histological grade,residual lesion size,and exfoliated cytology were not statistically significant.4、The overall survival of the platinum resistance relapse group was significantly lower than that of the sensitive relapse group(P<0.05).The difference was statistically significant.5、The overall survival of the NACT-IDS group and the overall survival of the PDS group P>0.05,the difference was not statistically significant.Conclusions:1、Patients with FIGO staging(Ⅳ),platelet counts(>300×109/L),and patients with higher than normal CA125 values after two chemotherapy are more likely to have drug resistant relapses and have poorer prognosis,suggesting FIGO staging,platelet counts,and two chemotherapy.Posttransplantation of CA125 is an independent risk factor for the relapse resistance of advanced epithelial ovarian cancer;Histological grade(non-high level),ascites cytology cytology(detection of cancer cells),residual lesion size(>1cm)and other factors were associated with drug-resistant recurrence of epithelial ovarian cancer in the evening,but it was not an independent risk factor;2、Regarding age,pathological type,presence or absence of intraperitoneal chemotherapy,initial tumor size,presence or absence of pleural effusion,ascites,maximum metastases,baseline CA125,and whether neoadjuvant chemotherapy was performed before surgery,there were no statistically significant factors in this study.Need large sample size of prospective studies;3、NACT-IDS did not increase the patient’s risk of drug resistance,nor did it improve overall patient survival;Patients with recurrent platinum resistance in advanced epithelial ovarian cancer have shorter survival than platinum-sensitive recurrence and have a poor prognosis. |
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