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目的 :研究影响卵巢癌患者预后的临床和生物学因素。方法 :回顾分析卵巢癌患者 88例的临床资料 ,并检测肿瘤组织上皮中血管内皮生长因子 (VEGF)和胸苷磷酸化酶 (TP)的表达及肿瘤间质内微血管密度 (MVD) ,应用Cox比例风险模型评估临床因素包括年龄、临床分期、组织学类型、细胞分化级别、术后残余癌灶及生物学因子 :VEGF、TP、MVD与总生存期 (OS)和无进展生存期 (PFS)之间的相关性。结果 :(1)患者的年龄、临床分期和术后癌灶大小显著影响其生存期的长短 ;(2 )Cox模型未发现VEGF、TP和MVD与OS和PFS之间的相关性 ;(3)低分化 (G3、G4 )肿瘤细胞中VEGF的表达显著高于高分化(G1、G2 )者。结论 :(1)年龄、临床分期和术后残余癌灶是三个独立的临床预测因子 ,表明早期诊断和适宜治疗极为重要 ;对老年患者应密切监护 ;(2 )低分化肿瘤细胞比高分化肿瘤细胞具有更恶的基因型和表现型 ,更易诱导间质内微血管生成 ,促进肿瘤的复发、转移和快速生长 ,提示抗微血管生成治疗肿瘤的可行性
Objective: To study the clinical and biological factors that influence the prognosis of patients with ovarian cancer. Methods: The clinical data of 88 patients with ovarian cancer were retrospectively analyzed. The expression of vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP) and tumor interstitial microvessel density (MVD) in tumor tissue were detected. Cox Proportional risk model evaluated clinical factors including age, clinical stage, histological type, cell differentiation grade, postoperative residual tumor and biological factors: VEGF, TP, MVD and overall survival (OS) and progression-free survival (PFS) The correlation between. Results: (1) The age, clinical stage and size of postoperative cancer significantly affected the survival of patients. (2) The correlation between VEGF, TP, MVD and OS and PFS was not found in Cox model. (3) The expression of VEGF in poorly differentiated (G3, G4) tumor cells was significantly higher than that in well-differentiated (G1, G2). Conclusion: (1) Age, clinical stage and postoperative residual foci are three independent clinical predictors, indicating that early diagnosis and appropriate treatment are extremely important; elderly patients should be closely monitored; (2) poorly differentiated tumor cells are highly differentiated Tumor cells have a worse genotype and phenotype, more likely to induce interstitial microangiogenesis, promote tumor recurrence, metastasis and rapid growth, suggesting the feasibility of anti-angiogenesis in the treatment of tumors