绝经前卵巢上皮性癌预后因素分析

[摘要] 目的 探讨影响绝经前卵巢上皮性癌患者生存预后的相关因素。 方法 回顾性分析2000年1月～2007年1月共163例绝经前卵巢上皮性癌患者临床资料，评估预后因素。随访时间为5年，各分层因素间生存率比较采用χ2检验，寿命法计算生存率，Kaplan-meier法分析变量，Log-rank法检验生存差异，COX多因素模型进行多因素分析。 结果 绝经前卵巢上皮性癌患者2年生存率为79.75%，5年生存率为46.01%。单因素逐步COX模型分析与分层因素间生存率比较结果显示：临床分期、病理类型、细胞学分级、残留灶大小、手术方式是影响预后的重要因素（P < 0.01）。逐步COX模型多因素分析显示：其细胞学分级、残留灶大小、手术方式是影响预后的独立因素（P < 0.01）。单因素Logistic回归分析显示：不同因素下各组间5年生存率存在差异（P < 0.01）。 结论 绝经前卵巢上皮性癌患者临床分期早，细胞分化好，术后残余病灶越小，预后越好，根据以上因素可预测绝经前卵巢上皮性癌患者生存概率。

[关键词] 卵巢上皮性癌；绝经前；预后因素

[中图分类号] R737.31 [文献标识码] A [文章编号] 1673-7210（2012）08（c）-0026-03

Clinical analysis about prognostic factors of the ovarian epithelial cell in cancer premenstrual woman

LIN Lihong GUO Yu

The Second Ward of Gynecology, Anyang Tumor Hospital, He′nan Province, Anyang 455000, China

[Abstract] Objective To investigate prognostic factors of the premenstrual woman with ovarian epithelial cell cancer. Methods From January 2000 to January 2007, the data on 163 cases of patients were collected,and the factors which affected prognosis were retrospectively analyzed. Based on five years of follow-up, the survival rate was compared between layer factors with chi-square test, life method was used in calculation of survival, Kaplan-meier, Log-rank and COX multi-factor mode analytic method was respectively adopted to analyze variables, survival differences and multi-factors analysis. Results The 2-year survival rate was 79.07%, with a 46.01% 5-year survival rate; the cytology grade, residual tumor size and the method of surgery were prognostic factors (P < 0.01) according to the Cox-model multifactor results; based on the COX model multi-factor analysis, cytology classification, residual focal size, the operation method were the independent factors affecting the prognosis (P < 0.01); A statistical significance was found about the 5-year survival rate between every group under a different layer factors by a single factor Logistic regression analysis (P < 0.01). Conclusion The research data shows earlier staging, higher cell differentiation, fewer residual focal size, more optimistic prognosis for the premenstrual epithelial ovarian carcinoma.

[Key words] Oarian epithelial cell carcinoma; Premenopausal; Prognostic factor

卵巢癌是危害女性的妇科恶性肿瘤之一，5年生存率在30%以下[1]，好发于40～60岁妇女，平均年龄52岁[2]，而75%～90%卵巢为上皮性卵巢癌[3]，临床上对其预后因素进行分析将有助于准确判断患者预后，并有利于个体化治疗方案的选择。本文回顾性分析163例绝经前卵巢上皮性癌患者临床资料，探讨绝经前患者预后情况及影响因素，以制订合理的治疗方案，提高疗效，改善预后。

1 资料与方法

1.1 一般资料

2000年1月～2007年1月我院共收治163例绝经前卵巢上皮性癌患者，年龄9～54岁，平均（38.9±1.36）岁。所有患者入院时均未绝经，经手术治疗并按照1992年FIGO标准进行病理分期，术后经病理检验确定病理类型及细胞学分级。病理类型：浆液性腺癌72例（44.2%），黏液性腺癌56例（34.3%），子宫内膜样腺癌21例（12.9%），交界性癌局限性癌变5例（3%），未分化癌9例（5.5%）。病理分期：Ⅰ期41例（25.2 %），Ⅱ期58例（35.6%），Ⅲ期51例（46.6%），Ⅳ期13例（8%）；细胞学分级：G1期43例（26.4%），G2期76例（46.6%），G3期44例（27%）。