The prognostic significance of thrombocytosis in epithelial ovarian carcinoma
The prognostic significance of thrombocytosis in epithelial ovarian carcinoma
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DOI：
10.1016/j.ygyno.2003.09.002
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发表时间：
2004-01-01
影响因子：
4.7
通讯作者：
Karlan, BY
中科院分区：
文献类型：
--
作者：
Li, AJ;Madden, AC;Karlan, BY
客观的。本研究的目的是确定上皮性卵巢癌血小板增多的发生率并检查其与临床病理特征的关联。血小板增多症（血小板计数>400 x 10(9)/1）已被确定为许多癌症的不良预后因素。血小板分泌因子可能有助于转移、侵袭和原发性肿瘤生长。方法。 1996年1月至2000年12月期间，鉴定了183名患有浸润性上皮性卵巢癌或原发性腹膜癌的患者。使用chi(2)、Student's t检验和Cox比例风险模型对记录进行回顾性审查和数据分析；采用Kaplan和Meier的方法分析生存率。结果。 183 名患者中有 41 名 (22.4%) 在初步诊断时患有血小板增多症。术前血小板增多的患者 CA-125 升高程度更高（P = 0.026），疾病分期更晚期（P = 0.016），肿瘤级别更高（P = 0.010），淋巴结转移更频繁（P = 0.018），腹水量更大（P < 0.0001）。 183 名患者中的 160 名 (87.4%) 实现了最佳细胞减灭术；血小板增多症患者表现出次优切除的可能性更大（残留病灶 >1 cm；无血小板增多症患者为 19/41 与 4/142，P < 0.0001）。血小板增多症患者的无病间隔期较短（12 个月与 34 个月，P < 0.0001），总生存期较短（28 个月与 79 个月，P < 0.0001）。在多变量分析中，血小板增多作为 III 期和 IVA 疾病患者的不良预后指标仍然具有重要意义（P = 0.04）。结论。血小板增多症是卵巢癌和腹膜癌术前常见的发现，可能是侵袭性肿瘤生物学的标志。 (C) 2003 Elsevier Inc. 保留所有权利。
Objective. The objective of this study was to determine the incidence of thrombocytosis in epithelial ovarian carcinoma and examine associations with clinico-pathologic features. Thrombocytosis (platelet counts >400 x 10(9)/1) has been identified as a poor prognostic factor in many cancers. Platelet-secreted factors may contribute to metastasis, invasion, and-primary tumor growth.Methods. One hundred eighty-three patients with invasive epithelial ovarian or primary peritoneal carcinomas were identified between January 1996 and December 2000. Records were retrospectively reviewed and data analyzed using chi(2), Student's t test, and Cox proportional hazards model; survival was analyzed by the method of Kaplan and Meier.Results. Forty-one of 183 (22.4%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have greater elevations of CA-125 (P = 0.026), more advanced stage disease (P = 0.016), higher grade tumors (P = 0.010), more frequent lymph node metastases (P = 0.018), and greater volume of ascites (P < 0.0001). One hundred sixty of 183 (87.4%) patients achieved optimal cytoreduction; patients with thrombocytosis demonstrated a greater likelihood of suboptimal resection (residual disease >1 cm; 19/41 vs. 4/142 in patients without thrombocytosis, P < 0.0001). Patients with thrombocytosis had a shorter disease-free interval (12 vs. 34 months, P < 0.0001) and overall survival (28 vs. 79 months, P < 0.0001). On multivariate analysis, thrombocytosis retained significance as a poor prognostic indicator in patients with stage III and IVA disease (P = 0.04).Conclusions. Thrombocytosis is a frequent preoperative finding in ovarian and peritoneal carcinomas and may be a marker of aggressive tumor biology. (C) 2003 Elsevier Inc. All rights reserved.