Analysis Of Factors Affecting Recurrence Of Epithelial Ovarian Cancer And A Clinical Study On The Prediction Of Recurrence By ROMA Index

Part I Analysis of factors affecting recurrence of epithelial ovarian cancerObjective Through the survival analysis,the general situation,tumor situation,tumor markers and treatment methods of patients were analyzed to explore the related factors that affect the recurrence of epithelial ovarian cancerMethods From January 2015 to January 2019,99 patients with epithelial ovarian cancer were selected from the general hospital and Tumor Hospital of Ningxia Medical University who received initial treatment?satisfactory tumor cell reduction combined with chemotherapy?and achieved complete remission according to RICEST standard.They were followed up to December 2019.The recurrence was observed as the outcome and end point,and the recurrence free survival period?RFS?was calculated in months.The average follow-up period of the patients was 13 months,41 cases recurred,58 cases did not recur.The age,menopausal state,ascites,single or double sides of tumor,clinical stage,pathological type,histological grade,tumor markers such as CA125,HE4,Roma index,neoadjuvant chemotherapy,lymphadenectomy,chemotherapy cycle were collected.The relationship between recurrence rate and various factors was analyzed by calculating recurrence rate and drawing recurrence free survival rate To establish recurrence free survival curve and analyze the relationship between factors and recurrence free survival.SPSS22.0 was used to analyze the data.P<0.05 was statistically significant.Results 1.Recurrence:among the 99 patients included in the study,41 recurred,with a recurrence rate of 41.41%and an average recurrence time of 10.3 months.2.Analysis of factors affecting the recurrence of epithelial ovarian cancer:the results showed that age,whether there was ascites,tumor single and bilateral,clinical stage of tumor,CA125 before and after treatment,HE4 before and after treatment,Roma index before and after treatment,neoadjuvant chemotherapy and chemotherapy cycle had influence on the recurrence of EOC(c2age=6.219,c2ascites=7.990,c2single and double sides=4.986,c2clinical stage=24.366,c2CA125 before treatment=22.806,c2 HE4 before treatment=20.686,c2 HE4 after treatment=11.371,c2Roma index before treatment=24.069,c2Roma index after treatment=7.990,c2lymphadenectomy=1.963,c2neoadjuvant chemotherapy=9.105,c2_{chemotherapy cycle}=11.172,the difference was statistically significant P<0.05).3.Analysis of factors affecting the RFS of epithelial ovarian cancer:Kaplan Meier method analysis result showed age,ascites,tumor single and double sides,FIGO stage,CA125 before treatment,HE4 before and after treatment,Roma index before and after treatment,neoadjuvant chemotherapy,chemotherapy cycle were correlated with recurrence free survival of epithelial ovarian cancer patients(Log-rankc² _age=4.027,Log-rankc² _ascites=8.381,Log-rankc² _{single and double sides}=6.651,Log-rankc² _{clinical stage}=20.801,Log-rankc^2t_{CA125 before treatmen}=19.212,Log-rankc² _{HE4 before treatment}=18.844,Log-rankc² _{HE4 after treatment}=8.007,Log-rankc² _{Roma index}oma index before treatment=21.116,Log-rankc2 Roma index after treatment=6.505,Log-rankc2 neoadjuvant chemotherapy=8.525,Log-rankc² _{chemotherapy cycle}=9.12,the difference was statistically significant?P<0.05?.Cox risk regression analysis of the independent factors of RFS in patients with epithelial ovarian cancer:FIGO stage?HR=10.654?,Roma index before treatment?HR=4.050?and lymphadenectomy HR?HR=0.430?an independent influence factor of epithelial ovarian cancer recurrence?P<0.05?.Conclusion 1.Age,ascites,single or bilateral tumor,FIGO stage,CA125 before treatment,level of HE4 and Roma index,and HE4,Roma index,neoadjuvant chemotherapy,chemotherapy cycle and relapse of epithelial ovarian cancer were correlated.2.FIGO stage,Roma index level before treatment,and lymphadenectomy are independent influence factors of RFS in patients with epithelial ovarian cancer.Part II A clinical study on the prediction of recurrence of epithelial ovarian cancer by ROMA indexObjective By analyzing CA125,HE4 and Roma index of relapsed patients,and drawing ROC curve of Roma index to diagnose the recurrence of epithelial ovarian cancer,to explore the clinical value of Roma index in predicting the recurrence of epithelial ovarian cancer.Methods The first part was divided into recurrent group?41 cases?and non recurrent group?58 cases?.The serum CA125,he and Roma indexes were collected.Using spss22.0software to compare the positive rate,draw the working characteristic curve?ROC?,calculate the ROC index,CA125,and the AUC,cutoff value,sensitivity and specificity of HE4 diagnosis,and analyze the clinical value of the ROC index in predicting the recurrence of epithelial ovarian cancer.Results Comparison of positive rates of Roma index,serum CA125 and HE4 in relapsed group: the positive rates of Roma index and CA125 in relapsed group were 90.24%and 80.49% respectively,significantly higher than that of HE4?58.54%?.The difference was statistically significant?c2= 12.002,P <0.05?.2.The time of the first increase of serum CA125,HE4 and Roma index after treatment was compared with that of imaging diagnosis:the time of serum CA125,HE4 and Roma index was 2-3 months earlier than that of imaging diagnosis of epithelial ovarian cancer recurrence,the difference was statistically significant?F= 1.530,P < 0.05?.3.The value of serum CA125,HE4 and Roma index in the prediction of epithelial ovarian cancer recurrence: the area under ROC curve of serum CA125,HE4 and Roma index in the diagnosis of epithelial ovarian cancer recurrence was 0.937,0.892 and0.956,respectively,and Roma index was better than CA125 and HE4 in the diagnosis of ovarian cancer recurrence.4.The best critical values of serum CA125,HE4 and Roma index in predicting the recurrence of epithelial ovarian cancer were 25.54u/ml,87.75pmol/l and 14.14% respectively.The sensitivity was 82.9%,70.73% and 90.2% respectively.The specificity was 96.6%,91.38%,91,4% respectively.The sensitivity of Roma index was better than that of CA125 and HE4.Conclusion 1.The rise of Roma index can predict the recurrence of recurrent epithelial ovarian cancer.2.The critical value of Roma index in the diagnosis of epithelial ovarian cancer recurrence was 14.14%,and the sensitivity of Roma index was better than CA125 and HE4.