58例晚期卵巢癌患者发生腹腔内转移后的临床特征、疗效及预后影响因素分析  

The clinical features,curative effect and prognosis factors analysis in 58 patients with advanced ovarian cancer after intraperitoneal metastases

作　　者：余东阳 刘梓良[1] 韩丽蓉[1] 

机构地区：[1]湖北省天门市第一人民医院,天门431700

出　　处：《实用肿瘤学杂志》2016年第4期321-326,共6页Practical Oncology Journal

摘　　要：目的探讨晚期卵巢癌患者发生腹腔转移后的临床特点、疗效,并探讨预后的影响因素。方法回顾性分析湖北省天门市第一人民医院肿瘤科3个病区2013年1月—2016年1月期间病理诊断明确、初诊且临床资料齐全的65例晚期卵巢癌患者,其中发生腹腔转移的58例,对58例患者预后影响因素进行单因素和多因素生存分析。结果 58例诊断卵巢癌腹腔转移患者的平均年龄为(49.2±6.5)岁,从确诊卵巢癌到发生腹腔转移的平均时间为11个月,卵巢癌腹腔转移患者的中位生存时间为8周,而7例未发生腹腔转移者的中位生存时间为15周。单因素生存曲线比较显示,患者婚姻状况、生育史、哺乳史、恶性腹水、新辅助化疗、综合治疗(化疗+开腹的肿瘤细胞减灭术+腹腔热灌注化疗)、腹腔转移瘤数目、残余病灶大小、患者的生存质量(卡氏评分)、血浆中D-二聚体水平、尿液中微量白蛋白的水平与患者的预后均有关(P<0.05)。Cox多因素回归模型分析显示,患者生育史、综合治疗、血浆中D-二聚体的水平、尿液中微量白蛋白水平为影响患者预后的独立危险因素(P<0.05)。结论晚期卵巢癌腹腔转移患者生存时间短,预后差;新辅助化疗联合肿瘤细胞减灭术及术后腹腔热灌注化疗,短期疗效好,既能提高晚期卵巢癌治疗有效性,又可改善晚期患者的生存质量;治疗前血浆中D-二聚体水平以及尿液中微量白蛋白持续维持在高水平或者不降低的患者,治疗效果差,预后也差,提示二者可以作为一种新的判断预后的指标。Objective To explore the clinical characteristics and the influence factors of prognosis of ad -vanced ovarian cancer patients after abdominal metastases .Methods We retrospectively analyzed 65 cases dur-ing January 2013 to January 2016 in the First People′s Hospital of Tianmen .The patients were diagnosed clearly with pathological ,diagnosed for the first time and has the complete clinical data including peritoneal metastases in 58 cases,which were analyzed for single factor and multiple factors of influencing factors survival analysis .Results 58 cases of patients with diagnosis of peritoneal metastasis in ovarian cancer that the average is （49.2 ±6.5）, from ovarian cancer diagnosis to abdominal metastases for an average time of 11 months,ovarian cancer patients with peritoneal metastasis of the median survival time was 8 weeks,but 7 cases without abdominal metastases that the median survival time was 15 weeks.The single factor survival curves（Kaplan-meier）showed that marital sta-tus,reproductive history,history of breastfeeding,malignant ascites,neoadjuvant chemotherapy,comprehensive treatment（chemotherapy and tumor cells to destroy the loss and laparotomy abdominal hot perfusion chemothera -py） ,peritoneal metastasis tumor number ,residual lesion size ,quality of life in patients with residual lesions （ KPS scores）,D-dimer level in plasma and urine trace albumin levels related to the prognosis of patients （P〈0.05）. Conclusion Patients with advanced ovarian cancer patients with peritoneal metastasis survival time is shorter , and also company with poor prognosis;Neoadjuvant chemotherapy combined tumor cells to destroy the loss and postoperative intraperitoneal hot perfusion chemotherapy ,short-term curative effect is good ,it can not only im-prove the advanced ovarian cancer treatment effectiveness ,but also improve the quality of life in patients of late phase.The D -dimer level in plasma and urine trace albumin levels before treatment have remained in the pa-tients with high level or

关 键 词：卵巢癌 腹腔转移 预后 

分 类 号：R737.31[医药卫生—肿瘤]