摘要
目的:分析卵巢浆液性腺癌的预后相关因素,建立量化的预后评分模型并检验该模型的效用。方法:分别收集1995年1月—2003年12月卵巢浆液性腺癌训练样本(181例)以及1999年1月—2005年12月卵巢浆液性腺癌检验样本(42例)的临床资料进行回顾性分析。应用Kaplan-Meier单因素生存分析筛选预后相关因素,COX单因素和多因素回归分析确定各分层因素的系数,Pearson等级相关分析了解各因素之间的相关性,将风险系数转换为评分,建立卵巢浆液性腺癌预后评分模型。应用受试者工作特征(receiver operating characteristic,ROC)曲线分析判断界值,结合患者实际的3年生存情况和Ki67值,检验预后评分模型的敏感度和特异度。结果:卵巢浆液性腺癌患者的生存率与临床分期、病理分级、手术残余病灶大小、淋巴结转移情况、术后化疗情况和术前血清CA125水平等6项因素相关,其中术后化疗是相对独立的预后因素。该预后评分模型能够直观地反映COX风险比例模型的生存率。将预后评分与Ki67值进行联合判断时,其敏感度和特异度分别可达64.7%和96.0%。结论:临床分期、病理分级、手术残余病灶大小、淋巴结转移情况、术后化疗情况和术前血清标志物CA125水平是影响卵巢浆液性腺癌患者预后的主要因素。卵巢浆液性腺癌预后评分模型能够较好地反映患者的实际生存情况,预后评分与Ki67值进行联合判断可以显著提高该模型的敏感度和特异度。
Objective：To analyze the prognosis-related factors of ovarian serous adenocarcinoma in order to set up a prognostic model of serous adenocarcinoma and verify the effectiveness of the model as prognostic clinical criteria.Methods：The clinical,patholo-gical and follow-up data from 181 training samples with ovarian serous adenocarcinoma in Peking University First Hospital during January 1995 to December 2003 and another 42 detection samples with ovarian serous adenocarcinoma in Beijing Cancer Hospital during January 1999 to December 2005 were analyzed retrospectively. Kaplan-Meier univariate analysis was used to screen out prognostic factors; COX univariate and multivariate analyses were used to determine the risk coefficient of each factor and different layers in each factor; Pearson rank correlation analysis was used to identify the correlation of each factor. The prognostic model of ovarian serous adenocarcinoma was established on the conversion of risk coefficient to prognostic score and receiver operating characteristic （ROC） analysis was used to determine the cut-off value. The clinical data were collected to verify the sensitivity and specificity of the prognostic model based on the 3-year survival rate and Ki67 value.Results：The survival rate of patients with ovarian serous adenocarcinoma correlated with 6 factors including FIGO stage,histological grade,residual size,metastasis of lymph nodes,general condition after chemotherapy,and serum CA125 levels. The postoperative chemotherapy was an independent factor for prognosis. The prognostic model directly reflected the survival probability of classical COX risk ratio model,with higher score indicating lower survival probability and poorer prognosis. If combining prognostic score with Ki67 the sensitivity and specificity reached 64.7% and 96.0%,respectively.Conclusion：FIGO stage,histological grade,residual size,metastasis of lymph nodes,postoperative chemotherapy and serum CA125 were the prognostic factors of patients with ovarian serous adenocarcino
出处
《肿瘤》
CAS
CSCD
北大核心
2010年第2期125-129,共5页
Tumor
关键词
卵巢肿瘤
腺癌
浆液性
预后
模型
统计学
Ovarian neoplasms
Adenocarcinoma, serous
Prognosis
Models, statistical
