卵巢癌临床和生物学预测因子研究  

The study of clinicaland biological prognostic factor in ovarian cancer.

作　　者：张慧娟[1] Sanjiv Manek Han Chen Trivadi S.Ganesan 

机构地区：[1]上海市第六人民医院妇产病理研究室,上海,200233 [2]Department of Cellular Pathology,John Radcliffe Hospital,Oxford,UK [3]Imperial Cancer Research Fund,Medical Statistics Group,Oxford University,UK [4]Imperial Cancer Research Fund,IMM,Oxford University,UK

出　　处：《现代妇产科进展》2002年第4期251-254,共4页Progress in Obstetrics and Gynecology

基　　金：英国皇家癌症研究基金会 (imperialcancerresearchfund ICRF)资助

摘　　要：目的 :研究影响卵巢癌患者预后的临床和生物学因素。方法 :回顾分析卵巢癌患者 88例的临床资料 ,并检测肿瘤组织上皮中血管内皮生长因子 (VEGF)和胸苷磷酸化酶 (TP)的表达及肿瘤间质内微血管密度 (MVD) ,应用Cox比例风险模型评估临床因素包括年龄、临床分期、组织学类型、细胞分化级别、术后残余癌灶及生物学因子 :VEGF、TP、MVD与总生存期 (OS)和无进展生存期 (PFS)之间的相关性。结果 :(1)患者的年龄、临床分期和术后癌灶大小显著影响其生存期的长短 ;(2 )Cox模型未发现VEGF、TP和MVD与OS和PFS之间的相关性 ;(3)低分化 (G3、G4 )肿瘤细胞中VEGF的表达显著高于高分化(G1、G2 )者。结论 :(1)年龄、临床分期和术后残余癌灶是三个独立的临床预测因子 ,表明早期诊断和适宜治疗极为重要 ;对老年患者应密切监护 ;(2 )低分化肿瘤细胞比高分化肿瘤细胞具有更恶的基因型和表现型 ,更易诱导间质内微血管生成 ,促进肿瘤的复发、转移和快速生长 。Objective:To explore the clinical and biological factors which affect the prognosis of ovarian cancers.Methods:88 successive ovarian cancers (hospitalized between 1990 1993) were studied.Each case was stained for vascular endothelial growth factor(VEGF) and thymidine phosphorylase(TP) ,and intratumor microvessel density( MVD) was also counted.Theclinical data including age,stage,residual disease,histological type and gradewere retrospectively reviewed.The relationship between these variables and outcome measures(overall survival,OS and progression free survival, PFS) was evaluated by Cox proportion hazards model.Results: (1)The patient's PFS and /or OS was significantly related with age,stage and residual focus;(2) None of TP,VEGF and MVD showed relationship with OS or PFS;(3) There was stronger expression of VEGF in high grade (G 3,G 4)ovarian cancer cell than that in low grade (G 1,G 2)cancer cell. Conclusions:(1) Age,stage and residual disease are three independent prognostic factors which suggest early diagnosis and optimal treatment will improve survival.Older patients should be under close care;(2)The stronger expression of VEGF in high grade ovarian cancer means a more aggressive tumor genotype and phenotype,which is beneficial tometastasis,recurrence and rapid growth by inducing stroma angiogenesis.A new therapeutic intervention mediated by anti angiogenesis is feasible.

关 键 词：卵巢肿瘤 总生存期 无进展生存期 预测因子 内皮生长因子 胸苷磷酸化酶 预后 微血管密度 

分 类 号：R737.31[医药卫生—肿瘤]