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目的通过分析卵巢浆液性腺癌的预后相关因素,建立其预后评分模型,并应用于临床预测患者的生存概率。方法对北京大学人民医院104例卵巢浆液性腺癌患者的临床病理资料进行回顾性分析。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预后相关因素内分层因素及各预后相关因素的风险系数；Pearson等级相关分析剔除各预后相关因素间的相互影响。根据上述两个风险系数对各预后相关因素进行评分,建立预后评分模型,据此预测患者的生存概率。结果单因素生存分析显示,手术病理分期(P=0．0029)、病理分级(P= 0．0054)、术后残留灶直径(P=0．0000)、淋巴结转移(P=0．0000)以及化疗情况(P=0．0000)是卵巢浆液性腺癌的预后相关因素。Pearson等级相关分析显示,手术病理分期对预后的影响最大,随后依次为化疗、淋巴结转移、病理分级以及术后残留灶直径(其独立风险系数分别为1．3392、0．9206、0．7071、0．6004、0．4985)。根据预后风险系数对各预后相关因素进行评分,得到了卵巢浆液性腺癌的预后评分模型。通过该模型量化了化疗和术后残留灶直径这两个可变因素对患者生存概率的影响。随着预后评分的增加,患者的生存概率降低。结论通过筛选影响预后的相关因素,建立卵巢浆液性腺癌的预后评分模型。该模型可以量化预后相关因素,尤其是化疗和残留灶直径这两个指标,预测患者的生存概率,为临床工作提供了一种科学判断预后的方法。
Objective To analyze the prognostic factors of ovarian serous adenocarcinoma and establish a prognostic score model and apply it in clinical prediction of the survival probability of patients. Methods The clinical and pathological data of 104 cases of ovarian serous adenocarcinoma from Peking University People’s Hospital were retrospectively analyzed. Kaplan-Meier single-factor survival analysis screening prognostic factors; COX univariate and multivariate regression analysis to determine the prognostic factors within the stratification factors and prognostic factors related risk factors; Pearson rank correlation analysis excluding each prognostic factors influences. Based on the above two risk factors, the prognostic factors were scored and a prognostic score model was established, and the survival probability of the patients was predicted. Results The univariate survival analysis showed that the diameter of residual tumor (P = 0.0000), lymph node metastasis (P = 0.0000), pathologic grade (P = 0.0029) And chemotherapy (P = 0.0000) were prognostic factors of ovarian serous adenocarcinoma. Pearson rank correlation analysis showed that the pathological stage of surgery had the greatest impact on prognosis, followed by chemotherapy, lymph node metastasis, pathological grading and postoperative residual tumor diameter (the independent risk coefficients were 1.3392, 0.9206, 0.7071, 0.6004, 0.4985). According to the prognostic risk coefficient, the prognostic factors were scored and the prognostic score model of ovarian serous adenocarcinoma was obtained. The model was used to quantify the effect of two variables, chemotherapy and postoperative residual diameter, on the survival probability of patients. As the prognostic score increases, the patient’s survival rate decreases. Conclusion The prognostic scoring model of ovarian serous adenocarcinoma was established by screening relevant factors that influence prognosis. The model can quantify the prognosis-related factors, especially the two indexes of chemotherapy and residual diameter, predict the survival probability of patients, and provide a scientific method of prognosis for clinical work.