晚期卵巢上皮性癌的预后变化及影响因素分析  

Prognosis and Prognostic Factor Analysis of Advanced Epithelial Ovarian Cancer

作　　者：温宏武[1] 孙伟杰[1] 郭燕燕[1] 刘书文[1] 

机构地区：[1]北京医科大学第一医院妇产科

出　　处：《中华妇产科杂志》1997年第3期159-162,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：了解近２０余年晚期卵巢上皮性癌的预后有无改善，及影响预后的因素。方法：对１９７０年至１９９３年在我院住院治疗的１４０例晚期卵巢上皮性癌病例进行分析，按患者的初治时间分为两组，１９８０年１月以前的５６例为第１组，之后的８４例为第２组，计算两组的Ｋａｐｌａｎ－Ｍｅｉｅｒ生存率曲线，用ＳＰＳＳ及ＳＵＲＶＣＡＬＣ统计软件对资料进行单因素及ＣＯＸ逐步回归分析，确定影响患者预后的因素。结果：两组的病理资料无差异，但第２组得到了更积极的化疗。总的１年、２年及５年生存率分别为６１．２％、３２．１％和８．５％，第１组分别为４２．３％、２９．６％和４．５％，第２组分别为６９．３％、３６．２％和１１．２％，第２组预后好于第１组（Ｐ＜０．０５）。临床分期晚、分化差、残余瘤直径＞２ｃｍ者预后差。联合化疗≥４个疗程者预后改善，≥６个疗程者又较≥４个疗程者预后好。结论：晚期卵巢上皮性癌的预后近１０余年来有所改善，提高肿瘤细胞减灭术的彻底性及行至少６个疗程的联合化疗是改善预后的重要措施。Objective:To investigate the prognosis change and prognostic factors of advanced epithelial ovarian cancer in recent over twenty years. Methods:One hundred and fourty patients with advanced epithlial ovarian cancer were analyzed. They were divided into two groups based on their operation time. 56 patients operated before Jan. 1980 were included in the first group, and the other 84 patients in the second group. Kaplan Meier survival curves of the two groups were calculated, and COX model was used to evaluate the prognostic factors of the disease at univariate and multivarivate levels using SPSS and SURVCALC software. Results:There was no pathological difference in between the two groups, but the patients in the second group received more aggressive chemotherapy. The overall 1 , 2 and 5 year survival rates were 61.2%, 32.1%, and 8.5%, respectively. In the first group they were 42.3%, 29.6% and 4.5% respectively and in the second group 69.3%, 36.2%, and 11.2% respectively. The prognosis of the patients in the second group was better than that in the first group, P <0. 05. Univariate analysis revealed that stage, grade, residual tumor size and chemotherapy were significant predictors of patients'outcome. COX regression analysis identified that they were all independent prognostic factors. The patients with advanced, low grade, residual tumor (>2 cm) had poor prognosis. The prognosis of the patients who received equal or more than four, especially six cycles combined chemotherapy was improved. Conclusion: The prognosis of the patients with advanced ovarian cancer has improved in recent over 10 years, higher optimal cytoreductive rate and equal or more than six cycles combined chemotherapy are important measures for the better prognosis of advanced ovarian cancer.

关 键 词：卵巢肿瘤 预后 上皮性癌 

分 类 号：R737.310.7[医药卫生—肿瘤]