血浆D-二聚体、血栓调节蛋白与上皮性卵巢癌肿瘤细胞减灭术后铂类药物化疗敏感性的关系  

The relationship between plasma D-dimer,thrombomodulin and platinum chemosensitivity after tumor cell reduction surgery in epithelial ovarian cancer

作　　者：张晓欲[1] 左金玲[2] 董娜 高淑凤[1] ZHANG Xiaoyu;ZUO Jinling;DONG Na;GAO Shufeng(Department of Gynecology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China;Department of Obstetrics,Tangshan Maternal and Child Health Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]唐山市妇幼保健院妇科,河北唐山063000 [2]唐山市妇幼保健院产科,河北唐山063000

出　　处：《中国性科学》2024年第4期109-113,共5页Chinese Journal of Human Sexuality

基　　金：河北省医学科学研究计划项目(20191539,20231745)。

摘　　要：目的分析血浆D-二聚体(D-D)、血栓调节蛋白(TM)与上皮性卵巢癌肿瘤细胞减灭术后铂类药物化疗敏感性的关系。方法选取2019年6月至2022年5月唐山市妇幼保健院收治的137例行铂类药物化疗的上皮性卵巢癌患者作为研究对象,均完成肿瘤减灭术,在化疗前进行血液检查,检查项目包括肿瘤标志物、血浆D-D、TM及相关指标。根据化疗结束后复发时间定义复发类型,复发时间<6个月定义为铂耐药复发,反之定义为铂敏感复发,采用Cox回归分析血浆D-D、TM对上皮性卵巢癌肿瘤细胞减灭术后铂耐药复发的影响。结果137例患者成功随访6个月,其中25例在随访6个月内肿瘤复发,铂耐药复发率为18.25%。铂耐药患者国际妇产科联盟(FIGO)分期Ⅳ期、分化程度G_(3)级、手术满意度R1比例高于铂敏感患者,血清糖类抗原125(CA125)、人附睾蛋白4(HE4)、血浆D-D、TM表达高于铂敏感患者(P<0.05)。Cox回归分析结果显示,G_(3)级分化程度、手术满意度R1、血清CA125、HE4及血浆D-D、TM表达上调是上皮性卵巢癌铂耐药复发的影响因素(P<0.05)。结论血浆D-D、TM表达上调与上皮性卵巢癌铂耐药复发风险增加有关,铂类药物化疗前的血浆D-D、TM表达对于评估铂耐药复发风险具有一定意义。Objective To analyze the relationship between plasma D-dimer(D-D),thrombomodulin(TM)and platinum chemosensitivity after tumor cell reduction surgery in epithelial ovarian cancer.Methods A total of 137 patients with epithelial ovarian cancer who underwent platinum chemotherapy at Tangshan Maternal and Child Health Hospital from June 2019 to May 2022 were selected as study objects.All patients completed tumor cell reduction surgery and underwent blood tests before chemotherapy,including tumor markers,plasma D-D,TM,and related data.Type of recurrence was defined based on the recurrence time after chemotherapy.A recurrence time of less than 6 months was defined as platinum resistant recurrence,and vice versa was defined as platinum sensitive recurrence.Cox regression was used to analyze impact of plasma D-D and TM on platinum resistant recurrence after tumor reduction surgery for epithelial ovarian cancer.Results A total of 137 patients were successfully followed up for 6 months,of which 25 patients experienced tumor recurrence within 6 months,with a platinum resistant recurrence rate of 18.25%.Platinum resistant patients had a higher proportion of international federation of gynecology and obstetrics(FIGO)stageⅣ,grade G_(3)differentiation,and surgical satisfaction R1 than platinum sensitive patients.Serum carbohydrate antigen 125(CA125),human epididymal protein 4(HE4),and plasma D-D and TM expression were higher than platinum sensitive patients(P<0.05).Cox regression analysis result showed the degree of grade G_(3)differentiation,surgical satisfaction R1,serum CA125,HE4,and upregulation of plasma D-D,TM expression were the influencing factors for platinum resistance recurrence in epithelial ovarian cancer(P<0.05).Conclusions Upregulation of plasma D-D and TM expression is associated with the increased risk of platinum resistant recurrence in epithelial ovarian cancer.The expression of plasma D-D and TM before platinum drug chemotherapy has certain significance in predicting platinum resistant recurrence.

关 键 词：上皮性卵巢癌 铂类化疗 D-二聚体 血栓调节蛋白 化疗敏感性 

分 类 号：R711[医药卫生—妇产科学]