血浆D-二聚体水平与卵巢癌患者临床特征及化疗预后的关系研究

摘要

目的 探讨血浆D-二聚体(D-D)水平与卵巢癌患者临床特征及化疗预后的关系.方法 收集106例卵巢癌患者的临床资料,根据患者血浆D-D水平,将患者分为正常组(≤0.3 mg/L)及升高组(>0.3 mg/L).比较两组患者的临床特征、生存率,分析影响卵巢癌患者化疗预后的危险因素.结果 两组患者FIGO病理分期比较,差异有统计学意义(P﹤0.05);两组患者年龄、组织分化程度、淋巴结转移情况、病理类型及恶性腹腔积液情况比较,差异均无统计学意义(P﹥0.05).升高组患者中位OS及PFS分别为29.7个月(95%CI:27.6~31.8)、9.1个月(95%CI:7.7~10.4);正常组患者中位OS及PFS分别为38.6个月(95%CI:35.8~41.4)、16.1个月(95%CI:13.0~19.2);升高组患者中位OS及PFS明显低于正常组,差异均有统计学意义(Z=13.527、18.461;P﹤0.01).单因素分析结果显示年龄、FIGO病理分期、淋巴结转移、恶性腹腔积液、新辅助化疗、CA125水平、血浆纤维蛋白原、血小板、血浆D-D水平是卵巢癌患者化疗预后的影响因素(P﹤0.01),进一步经Cox回归模型分析结果显示,FIGO病理分期Ⅲ~Ⅳ期、有淋巴结转移、有恶性腹腔积液、无新辅助化疗、血浆D-D水平﹥0.3 mg/L是影响卵巢癌患者化疗生存预后的独立危险因素(P﹤0.01).结论 血浆D-D水平升高是影响卵巢癌患者化疗生存预后的独立危险因素,可作为评估卵巢癌患者化疗生存预后的指标.%Objective To investigate the relationship between plasma D-dimer (D-D) and the clinicopathological fea-tures and prognosis of patients with ovarian cancer.Method The clinical data of 106 cases with ovarian cancer were ret-rospectively analyzed,according to the level of plasma D-D,the patients were stratified as normal level group (≤0.3 mg/L) and elevated level group (>0.3 mg/L).The clinicopathological characteristics and survival rate of the two groups were compared,and the risk factors affecting prognosis of patients with ovarian cancer were analyzed.Result The difference of FIGO pathological staging between the two groups was statistically significant (P<0.05).There was no significant dif-ference in age,degree of differentiation,lymph node metastasis,pathological type and malignant ascites between the two groups (P>0.05).The median OS and PFS were 29.7 months (95%CI: 27.6-31.8) and 9.1 months (95%CI: 7.7-10.4) in the elevated level group,and the median OS and PFS were 38.6 months (95%CI: 35.8-41.4) and 16.1 months (95%CI:13.0-19.2) in the normal level group,the median OS and PFS in the elevated level group were significantly lower than those in the normal level group,and the difference was statistically significant (Z=13.527,18.461;P<0.01).The univari-ate analysis showed that age,FIGO staging,lymph node metastasis,malignant ascites,neoadjuvant chemotherapy,CA125 level,plasma fibrinogen,platelet and D-D levels were factors influencing the prognosis of patients with ovarian cancer after chemotherapy (P<0.01).Further Cox regression model showed that FIGO stage of Ⅲ-Ⅳ,presence of lymph node metastasis,malignant ascites,no neoadjuvant chemotherapy,D-D level>0.3 mg/L were the independent risk factors of prognosis for patients with ovarian cancer after chemotherapy (P<0.01).Conclusion The elevated level of plasma D-D is an independent risk factor of the survival and prognosis of patients with ovarian cancer,and it can be used as a sur-vival indicator for patients with ovarian cancer after chemotherapy.