| Objective: To compare the level of coagulation indexes between 119 patients with ovarian epithelial carcinoma and 100 patients with ovarian benign tumor,and different path ological types,presence of ascites,different surgical-pathological stages and different sizes of residual lesions showed differences in the levels of coagulation indexes in patients with ovarian epithelial carcinoma.To investigate the relationship between coagulation and ovarian epithelial carcinoma by analyze the relationship between the changes of coagulation function and the clinical features of patients with ovarian epithelial carcinoma.In order to provide the reference basis for the early diagnosis,condition evaluation,prognosis and the use of prophylactic anticoagulant therapy.Methods:1.119 patients with ovarian epithelial cancer who receiving initial surgical treatment in Yijishan Hospital of Wannan Medical College from May 2012 to August 2017,were selected as the observation group,and the control group included 100 cases of ovarian benign tumor.Relevant clinical information of the patients was collected and recorded,including age,prothrombin time,activated partial prothrombin time,fibrinogen,thrombin time,d-dimer,platelet count,CA125 level,intraoperative residual lesion size,ascites,pathological type,and pathological stage of FIGO surgery.2.The pathological types included serous carcinoma,mucinous carcinoma,endometrioid adenocarcinoma,clear cell carcinoma and other pathological types.No neoadjuvant chemotherapy was performed preoperatively and intraoperative visual description of the maximum diameter of residual lesions < 1cm was defined as ideal tumor cell depletion,and take this as the grouping standard.Intraoperative peritoneal effusion≥200ml was defined as ascites,and take this as the grouping standard.Surgical-pathological stages was performed according to the newly revised criteria of FIGO 2013.3.All values are expressed in terms of median and quartile spacing.Nonparametric U test was used to compare age and coagulation function between patients with benign ovarian neoplasms and ovarian epithelial carcinoma.Non-parametric U test or K-S test was used to compare the coagulation indexes and CA125 level among clinicopathological factors such as pathological type,r esidual lesion size,surgical-pathological stages and ascites status in the ovarian epithelial carcinoma group.ROC curve was drawn for surgical pathological staging and residual lesion size.Results: 1.The FIB,d-d and PLT counts of the ovarian epithelial carcinoma group were all higher than those of the ovarian benign tumor group,and the difference was statistically significant(P < 0.05);2.PLT count and CA125 of patients with ovarian epithelial carcinoma showed statistically significant difference(P < 0.05),There was no statistically significant difference in FIB,d-d,PT,APTT and TT among patients with different pathological types(P>0.05);3.Ⅲ-Ⅳ period patients of FIB,D-D,PLT count and CA125 levels were significantly higher than Ⅰ-Ⅱ period patients,the difference was statistically significant(P < 0.05);4.The PT,APTT,FIB,D-D,PLT count and CA125 in the ascites group were all higher than those in the no ascites group,and th e difference was statistically significant(P < 0.05);5.The PT,FIB,d-d,PLT count and CA125 of the > 1cm residual lesion group were significantly higher than those of t he no more than 1cm residual lesion group(P < 0.05);6.The ROC curve about coagul ation indexes for advanced ovarian carcinoma,shows that CA125(AUC = 0.818),D-D(AUC = 0.733)and FIB(AUC = 0.734)on diagnosis of ovarian epithelial carcinomaⅢ-Ⅳ has certain accuracy,PLT count for diagnostic accuracy is low;7.The ROC curve about coagulation indexes for residual lesion > 1cm in ovarian epithelial carcinoma shows that CA125 had a certain accuracy in the diagnosis of residual lesion > 1cm in epithelial carcinoma(AUC=0.729),while PT,D-D,PLT count and FIB had a lo w accuracy in the diagnosis.Conclusion: 1.Compared with patients with benign ovarian tumors,patients with ovarian epithelial cancer have obvious abnormal blood coagulation function,which is ma nifested by increased FIB,PLT count and D–D.2.There were significant differences in the hypercoagulable state between patients with ovarian epithelial cancer in different surgical-pathological stages,with or without ascites,and with different sizes of residual lesions,and no significant differences in th e hypercoagulable state between different pathological types.3.Patients who have ovarian epithelial carcinoma with ascites,late stage and the residual lesion was > 1cm have more significant hypercoagulable state and relatively poor prognosis.4.Monitoring the changes of coagulation indexes have great value in evaluating the condition,guiding the treatment and judging the prognosis of patients with epithelial ovarian cancer... |
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