摘要
目的:探究糖类抗原125消除速率常数K(KELIM)及BRCA突变状态对接受初次肿瘤细胞减灭术(PDS)的晚期高级别浆液性卵巢癌(HGSOC)患者的预后价值。方法:回顾分析2018年1月至2022年12月中国科学技术大学附属第一医院(安徽省立医院)收治的212例行PDS的晚期HGSOC患者的临床信息及随访资料,计算患者的KELIM值并分析其对晚期HGSOC患者的预后价值,同时探讨KELIM联合BRCA1/2基因突变状态对于患者的预后价值。结果:212例晚期HGSOC患者中KELIM值<1组102例(48.1%),KELIM值≥1组110例(51.9%)。KELIM<1组的化疗疗程数、使用抗血管生成药物比例高于KELIM≥1组(P=0.001)。Logistic回归分析结果显示,无肉眼残余病灶(P=0.005)、KELIM≥1(P=0.003)及携带BRCA突变(P=0.007)为有效的预测铂耐药因素。生存分析结果表明,无肉眼残余病灶、携带BRCA基因突变及KELIM≥1是影响患者无进展生存期(PFS)的独立预测因素(P<0.05);FIGOⅢ期(HR=0.420,95%CI为0.215~0.821)及KELIM≥1(HR=0.460,95%CI为0.234~0.908)是预测晚期HGSOC患者总生存期(OS)的独立影响因素。亚组分析中,KELIM对于BRCA基因突变患者的PFS及OS有显著预测价值,而在野生型患者中无显著差异。结论:KELIM值可作为评估晚期HGSOC患者预后的指标之一,尤其是携带BRCA基因突变的人群。
Objective:To explore the prognostic value of the modeled carbohydrate antigen 125 elimination rate constant K(KELIM)and BRCA mutation status in patients with advanced high-grade serous ovarian cancer(HGSOC)who have undergone primary debulking surgery(PDS).Methods:A retrospective analysis of clinical information and follow-up data from 212 patients with advanced high-grade serous ovarian cancer(HGSOC)who underwent primary debulking surgery(PDS)at the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from January 2018 to December 2022.To calculate the KELIM values of these patients and analyze their prognostic value,as well as to explore the combined prognostic value of KELIM and BRCA1/2 mutation status.Result:Among the 212 patients with advanced HGSOC,102(48.1%)had a KELIM value<1,and 110(51.9%)had a KELIM value≥1.The number of chemotherapy cycles and the proportion of patients receiving antiangiogenic agents were higher in the KELIM<1 group compared to the KELIM≥1 group(P=0.001).Logistic regression analysis indicated that the absence of visible residual disease(P=0.005),KELIM≥1(P=0.003),and BRCA mutations(P=0.007)were significant predictors of platinum resistance.Survival analysis showed that the absence of visible residual disease,BRCA mutations,and KELIM≥1 were independent predictors of progression-free survival(PFS)(P<0.05).FIGO stageⅢ(HR=0.420,95%CI 0.215~0.821)and KELIM≥1(HR=0.460,95%CI 0.234~0.908)were independent factors affecting overall survival(OS)in patients with advanced HGSOC.Subgroup analysis revealed that KELIM had significant prognostic value for PFS and OS in BRCA mutation carriers,whereas no significant differences were observed in BRCA wild-type patients.Conclusions:KELIM value can serve as one of the indicators for assessing the prognosis of patients with advanced HGSOC,particularly in those with BRCA gene mutations.
作者
江珊
朱靖
王莹莹
邢娟
申震
周颖
Jiang Shan;Zhu Jing;Wang Yingying(Department of Obstetrics and Gynecology,Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001;Department of Obstetrics and Gynecology,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001;Core Facility Center for Medical Sciences,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001)
出处
《现代妇产科进展》
2025年第3期185-190,195,共7页
Progress in Obstetrics and Gynecology
基金
国家自然科学基金(No:82303588,82473382)
安徽省重点研发项目(No:2022e07020013)
安徽省教育厅自然科学基金(No:2022AH051255)
2020年中国科学技术大学附属第一医院领先技术项目(No:2020LXJS-05)
北京科创基金(No:KC2021-JX-0186-143)。
