| Objective: To investigate the diagnostic and prognostic value of the Naples Prognostic Score(NPS)for epithelial ovarian cancer(EOC).Methods: A total of 248 patients with postoperative pathological diagnosis of EOC and321 patients with benign ovarian tumor(BOT)were selected from June 2014 to June 2021 at a Shengjing Hospital of China Medical University.Data were collected and organized,and patients were divided into three groups of A,B,and C according to the NPS scoring system.The differences in the distribution of patients in the BOT and EOC groups between the NPS groups were compared by chi-square test,and the value of the NPS in distinguishing between BOT and EOC was also analysed by plotting the receiver operating characteristic curve(ROC).The relationship between NPS and clinicopathological characteristics of EOC patients was analysed by chi-square test or Fisher’s exact probability method.Determining the value of NPS in predicting disease progression and death in patients with EOC by ROC curves.The correlation between NPS and progression free survival(PFS)and overall survival(OS)of EOC patients was analysed by one-way Cox regression model,and Cox multifactor analysis was performed for factors with P<0.05 to investigate the independent risk factors affecting PFS and OS of EOC patients.Cox multifactor analysis was performed to investigate the independent risk factors affecting PFS and OS in EOC patients.Results:1.There were significant differences between patients in the BOT and EOC groups in terms of age and menopausal status(P<0.05),but not in terms of body mass index(BMI),number of births,age at menarche and history of miscarriage.2.The majority of patients with BOT were distributed in NPS groups A and B,accounting for 91.3%,and the majority of patients with EOC were distributed in NPS groups B and C,accounting for79.8%.The distribution of patients among the three NPS groups was statistically significant(P<0.05);the area under the curve AUC of NPS to distinguish benign ovarian tumors from ovarian cancer was 0.622,which was statistically significant(P<0.05),with a 95% confidence interval of 0.576-0.669,a sensitivity of 30.2%,and a specificity of91.3%.3.NPS was significantly correlated with ascites,carbohydrate antigen 125(CA125)level,human epididymis protein 4(HE4)level and surgical pathological stage in patients with EOC,p<0.05.4.The AUC of NPS predicting progression in EOC patients was 0.592,which was statistically significant(P<0.05),with a 95% confidence interval of 0.524-0.670,sensitivity 40.4%,and specificity 74.8%;the AUC of NPS predicting death in EOC patients was 0.597,which was statistically significant(P<0.05),with a 95% confidence interval of 0.522-0.633,with a sensitivity of 38.2% and specificity of 76.8%.5.KaplanMeier survival analysis showed a significant shortening of PFS(Log Rank P<0.05)and OS(Log Rank P<0.05)in patients with early stage(stage I-II)EOC as the NPS group increased;whereas PFS and OS did not correlate significantly with NPS in patients with late stage(stage Ⅲ-Ⅵ).6.The results of the multifactorial analysis showed that the NPS2 group was an independent prognostic factor affecting PFS(p<0.05)and OS(p<0.05)in patients with early EOC.Conclusion: NPS has an adjunctive role in distinguishing BOT between EOC.Elevated NPS is an important indicator for assessing PFS and OS in patients with early EOC. |
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