益气活血解毒方加减或PARP抑制剂维持治疗与晚期卵巢癌复发转移的相关性——基于倾向性评分匹配的病例对照研究  

Association between Modified Yiqi Huoxue Jiedu Formula(益气活血解毒方)or PARP Inhibitors Maintenance Therapy and Recurrence and Metastasis in Advanced Ovarian Cancer:A Propensity Score Matched Case-Control Study

作　　者：崔永佳 卢雯平[1] 常磊 魏毅霖 王溪月 CUI Yongjia;LU Wenping;CHANG Lei;WEI Yilin;WANG Xiyue(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Postdoctoral Research Station,China Academy of Chinese Medical Sciences)

机构地区：[1]中国中医科学院广安门医院,北京市100053 [2]中国中医科学院博士后科研流动站

出　　处：《中医杂志》2025年第3期256-261,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82474354);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202205);中国中医科学院“优势病种-医院制剂-新药”研发专项(ZZ15-XYCT-05)。

摘　　要：目的探讨益气活血解毒方加减或多腺苷二磷酸核糖聚合酶(PARP)抑制剂维持治疗与卵巢癌复发转移的相关性。方法采用病例对照研究方法,根据卵巢癌患者一线维持治疗之后是否出现复发转移分为两组,出现复发转移者为病例组,未出现复发转移者为对照组。将既往一线维持治疗方式设定为研究的暴露因素(使用益气活血解毒方加减定义为暴露,使用PARP抑制剂定义为未暴露)。收集两组患者基线资料,包括R0手术切除、年龄、分期、是否行新辅助化疗、是否淋巴结转移、是否胚系BRCA1/2突变、是否存在同源重组修复缺陷、一线维持治疗方式(益气活血解毒方加减或PARP抑制剂)、末次化疗后CA125水平,对两组患者上述基线资料进行差异性检验,若存在差异,采用1∶1邻近匹配法进行倾向性评分匹配,采用单因素和多因素Logistic回归分析方法分析益气活血解毒方加减或PARP抑制剂与卵巢癌复发转移的相关性。结果共纳入201例晚期卵巢癌患者,其中病例组97例,对照组104例。两组患者在R0手术切除、分期、行新辅助化疗、末次化疗后CA125水平差异具有统计学意义(P<0.05),提示两组患者基线不均衡。进一步经倾向性评分匹配后,病例组和对照组各有71例患者,两组患者基线均衡(P>0.05)。单因素Logistic回归分析结果显示,R0手术切除(P=0.006)、分期(P=0.001)、行新辅助化疗(P=0.024)、一线维持治疗方式(P=0.006)、末次化疗后CA125水平(P=0.013)与卵巢癌的复发转移相关。多因素Logistic回归分析结果显示,分期是影响卵巢癌复发转移的独立影响因素(P=0.030),而一线维持治疗方式与卵巢癌的相关性P值为0.188。结论卵巢癌患者一线维持治疗使用益气活血解毒方加减或PARP抑制剂与卵巢癌复发转移不具有相关性。Objective To investigate the association between the maintenance treatment of modified Yiqi Huoxue Jiedu Formula (益气活血解毒方) or poly ADP ribose polymerase(PARP) inhibitors and the recurrence and metas-tasis of advanced ovarian cancer. Methods A case-control study design was employed, dividing patients with advanced ovarian cancer into two groups based on the occurrence of recurrence and metastasis following first-line maintenance treatment. Patients with recurrence and metastasis comprised the case group, while those without recur-rence and metastasis served as the control group. The previous first-line maintenance treatment method was set as the exposure factor in the study(with the use of modified Yiqi Huoxue Jiedu Formula defined as exposed and PARP inhibitors defined as unexposed). Basic information was collected for both groups, including the achievement of satisfactory R0 surgery, age, stage, neoadjuvant chemotherapy, lymph node metastasis, germline BRCA1/2 mutations, homologous recombination deficiency positivity, first-line maintenance treatment method(modified Yiqi Huoxue Jiedu Formula or PARP inhibitors), and CA125 levels after the last chemotherapy. The baseline data of the two groups were assessed for differences. If there exists difference, a 1∶1 nearest neighbor matching method was used for propensity score matching. Univariate and multivariate logistic regression analyses were employed to evaluate the association between the modified Yiqi Huoxue Jiedu Formula or PARP inhibitors and the recurrence and metastasis of ovarian cancer. Results A total of 201 patients with advanced ovarian cancer were included, with 97 in the case group and 104 in the control group. Both groups showed statistically significant differences in R0 surgery, stage, neoadjuvant chemo-therapy, and CA125 levels after the last chemotherapy(P<0. 05), indicating baseline imbalance. After propensity score matching, there were 71 patients in both the case and control groups, achieving baseline balance(P>0. 05). Univariat

关 键 词：卵巢癌 转移复发 益气活血解毒方 多腺苷二磷酸核糖聚合酶抑制剂 病例对照研究 

分 类 号：R737.31[医药卫生—肿瘤]