卵巢上皮癌预测模型及预后因素分析

发布时间：2018-04-29 09:20

本文选题：卵巢上皮癌 + CA125　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:比较不同治疗阶段卵巢上皮癌患者CA125、HE4及ROMA指数下降程度与患者预后的相关性,同时分析患者发病年龄、妊娠次数、病理类型、组织学分级、腹水及淋巴结转移对预后的影响,探讨CA125、HE4及ROMA指数三者对卵巢上皮癌的预测价值。方法:选取2011年7月~2016年11月就诊于吉林大学第一医院并经本院病理科确诊为卵巢肿瘤的患者,对比分析CA125、HE4及ROMA指数对卵巢上皮癌的预测及预后评估价值,分析发病年龄、绝经状态、绝经年龄、妊娠次数、病理类型、组织学分级、腹水及淋巴结转移对预后影响的差异。结果:1.血清CA125、HE4和ROMA指数三者对EOC诊断灵敏度逐渐升高,分别为91.2%、95.6%、96.7%,对应ROC曲线下面积也递增,分别为0.980、0.982、0.985,差异有统计学意义(P0.001)。2.ROMA指数对EOC的预后有较好的预测性。3.单因素卡方检验主要是确定各项因素对EOC复发率及预后的相关性。妊娠次数、流产次数、FIGO分期、组织学分级、腹水、淋巴结转移为有统计学意义的影响因素。通过多因素COX回归分析进一步研究发现,上述因素均是EOC的独立危险因素。结论:1.在卵巢肿瘤良恶性预测中,ROMA指数较CA125、HE4单项检测具有更好的预测价值。2.ROMA指数对EOC患者的预后具有更好的预测价值。3.发病年龄、绝经状态、绝经年龄、病理类型对EOC的预后没有影响。4.妊娠次数、流产次数、FIGO分期、组织学分级、腹水、淋巴结转移对EOC的预后有影响,并且是EOC患者预后的独立危险因素;妊娠次数越多、无流产史、FIGO分期越早、组织学分化程度越好、无腹水、无淋巴结转移者预后越好。
[Abstract]:Objective: to compare the relationship between the decrease of CA125 HE4 and ROMA index and the prognosis of patients with ovarian epithelial carcinoma at different stages of treatment, and to analyze the age of onset, the number of pregnancies, the pathological type and histological grade of the patients. To evaluate the prognostic value of CA125 HE4 and ROMA index in ovarian epithelial carcinoma. Methods: from July 2011 to November 2016, the patients who were diagnosed as ovarian neoplasms in the first Hospital of Jilin University and confirmed by the Department of Pathology of Jilin University were compared with CA125HE4 and ROMA index in predicting and evaluating the prognosis of ovarian epithelial carcinoma, and the age of onset was analyzed. Postmenopausal status, menopausal age, number of pregnancies, pathological type, histological grade, ascites and lymph node metastasis had different effects on prognosis. The result is 1: 1. The sensitivity of serum CA125 HE4 and ROMA index to the diagnosis of EOC increased gradually, 91.2 and 95.66.7respectively, and the area under the corresponding ROC curve was increased, respectively. The difference was statistically significant (P 0.001n 路2.ROMA index) for the prognosis of EOC. Single-factor chi-square test is mainly to determine the correlation of factors to the recurrence rate and prognosis of EOC. FIGO stage, histological grade, ascites and lymph node metastasis were statistically significant factors. By multivariate COX regression analysis, it was found that all the above factors were independent risk factors of EOC. Conclusion 1. In the prediction of benign and malignant ovarian tumors, roma index has better predictive value than CA125 He-4 single detection. 2. Roma index has better prognostic value for EOC patients. Age of onset, menopausal status, menopausal age and pathological type had no effect on prognosis of EOC. FIGO stage, histological grade, ascites and lymph node metastasis have influence on the prognosis of EOC, and are independent risk factors for prognosis of EOC patients, the more times of pregnancy, the earlier FIGO stage is without abortion history. The better histological differentiation, no ascites, no lymph node metastasis, the better prognosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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