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目的:研究血小板计数及纤维蛋白原(fibrinogen,FIB)水平与卵巢上皮性癌临床病理因素之间的相关性及其对预后的影响。方法:选取2012年6月至2016年6月在连云港妇幼保健院住院手术的卵巢上皮性肿瘤患者297例,其中卵巢上皮性癌患者137例,卵巢上皮性良性肿瘤患者160例作为对照。回顾性分析卵巢上皮性癌患者的临床病理资料以及良性肿瘤患者的年龄、术前血常规、凝血功能,术后病理资料等。计算血小板及FIB增多在卵巢良恶性肿瘤中的发生率,以及其与卵巢上皮性癌患者临床病理因素之间的相关性;所有卵巢上皮性癌患者随访至2017年6月,计算其总生存期(overall survival,OS)及无进展生存期(progress-free survival,PFS),分析血小板及FIB增多与其预后的关系。结果:卵巢上皮性癌患者血小板及FIB含量显著高于卵巢良性肿瘤患者,差异有统计学意义(P<0.05)。FIGO手术–病理分期越晚、分化程度越低、腹水量越多、术后残留肿瘤越大、术前CA125水平越高、术前肿瘤体积越小的患者合并血小板增多的发生率越高(P<0.05);FIB增多与FIGO手术–病理分期、腹水量、术后残留肿瘤大小及术前CA125水平有一定的相关性(P<0.05)。血小板增多是卵巢上皮性癌患者PFS的独立不良预后因子(P<0.05)。FIB增多与卵巢上皮性癌患者的预后无相关性。结论:血小板及FIB增多是卵巢上皮性癌常见现象之一,这可能与肿瘤的侵袭、转移相关;血小板增多是卵巢上皮性癌不良预后的危险因子。
Objective: To study the correlation between platelet count, fibrinogen (FIB) and clinicopathological factors of ovarian epithelial carcinoma and its effect on prognosis. Methods: A total of 297 ovarian epithelial tumors hospitalized in Lianyungang MCH from June 2012 to June 2016 were selected, of which 137 cases were ovarian epithelial carcinoma and 160 cases were ovarian benign tumor. The clinical and pathological data of patients with epithelial ovarian cancer were retrospectively analyzed, as well as the age, preoperative blood routine, coagulation function and postoperative pathological data of patients with benign tumor. The incidence of platelet and FIB in benign and malignant ovarian tumors was calculated and its correlation with clinical and pathological factors in patients with epithelial ovarian cancer was calculated. All patients with epithelial ovarian cancer were followed up until June 2017 to calculate their overall survival (OS) and progress-free survival (PFS). The relationship between platelet and FIB increased and its prognosis were analyzed. Results: The levels of platelet and FIB in ovarian epithelial cancer patients were significantly higher than those in benign ovarian tumors (P <0.05). FIGO surgery - the later the pathological stage, the lower the degree of differentiation, the greater the amount of ascites, the greater the residual tumor after surgery, the higher the preoperative CA125 level, the lower the preoperative tumor volume is associated with the higher incidence of thrombocytopenia (P <0.05). There was a significant correlation between FIB increase and FIGO operation-pathological stage, ascites volume, postoperative residual tumor size and preoperative CA125 level (P <0.05). Thrombocytosis is an independent, poor prognostic factor for PFS in patients with epithelial ovarian cancer (P <0.05). The increase of FIB has no correlation with the prognosis of patients with epithelial ovarian cancer. Conclusion: The increase of platelet and FIB is one of the common phenomena of epithelial ovarian cancer, which may be related to tumor invasion and metastasis. Thrombocytosis is a risk factor of poor prognosis of epithelial ovarian cancer.