70例卵巢上皮性癌复发相关因素的分析
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摘要
卵巢癌(ovarian cancer)是女性生殖系统常见肿瘤之一,其中85%-90%约为上皮性癌。由于卵巢处在盆腔深部,早期病变不易发现,故发现后70%已属晚期,加之在手术或联合化疗后仍有50%-80%的患者复发,导致其5年生存率低,死亡率居妇科恶性肿瘤之首。许多因素与卵巢癌复发有关。因此,通过归纳总结并详细分析这些因素与卵巢癌复发的关系,对于制定个体化的治疗方案、改善患者预后、延缓复发时间、提高患者生存率有积极意义。本文对2000年1月至2010年1月吉林大学第一临床医院收治的接受手术治疗的191例卵巢癌患者(其中复发70例)进行回顾性分析,探讨各项临床参数(年龄、临床分期、肿瘤残余灶大小、腹水)、病理参数(病理类型、组织分级、淋巴结清扫)以及化疗(疗程数、新辅助化疗、化疗方案)等与复发性卵巢癌的关系。采用单变量及多变量分析的方法研究各因素与复发的关系:SPSS 11.5统计软件包对复发率进行卡方检验:Kaplan-Meier法进行生存分析,多变量分析采用Cox回归分析。P<0.05有统计学意义。结果表明:1、单变量分析中,临床分期、肿瘤残余灶大小、组织分级、化疗疗程数以及新辅助化疗为影响卵巢上皮性癌患者复发的因素;多变量分析中,临床分期、肿瘤残余灶大小、组织分级及化疗疗程数为影响患者复发的独立因素。2、卵巢癌临床期别越晚,治疗后复发可能性越大。因此,提高其早期诊断率对于改善患者预后、降低复发率,意义深远。3、对晚期卵巢癌患者,尤其合并腹水者,应用新辅助化疗可提高手术切除率,降低复发率。4、年龄、腹水脱落细胞、病理类型、淋巴结清扫及化疗方案在本研究中与上皮性卵巢癌复发无关。
Ovarian cancer is one of the most common gynecological malignancies,and 85%-90% of patients are epithetlial ovarian cancer. The early diagnosis is hard to make out beacuase the ovarian is located in the deep of the pelvic cavity,and when you discovered the cancer ,70% of the patients have been to the late stage age.After the surgery and chemotherapy treatments, 50%-80% of the patients recur.It leads to the low 5-year survical rate of the ovarian cancer. Many factors related with ovarian cancer recurrence. Therefore, it has positive significance to make indiidual treatments, improve the prognosis of patients with recurrent, delay time and improve patient surial rates by analysising and summaring these factors with ovarian cancer recurrence relationship. At present, many scholars think there are a few of factors is relevant to the recurrent epithelial ovarian.This research mainly from some aspects to analysis the relationship with the recurrent epithelial oarian cancer,such as clinical parameters of oarian cancer (the age, the clinical stages, residual tumor size, ascites) , pathological parameters (pathologic types, organization classification, lymph node dissection) and adjuvant chemotherapy.
Object:Explore the clinical, pathological and adjuvant chemotherapy for I - IV stage solid-cystic-papillary epithelial ovarian cancer patients who have recerived surgery treatment and recur.
Method:Retrospective review of 191 patients from the First Hospital of Jilin University with ovarian carcinoma treated surgically between January 2000 and January 2010, and 70 cases are fit for the standard to diagnose recurrent cancer. Using univariate and multivariate analysis method to discussed the various factors of the recurrent epithelial ovarian cancer,such as the clinical stages age, tumor size, ascites, focal residual pathological type, organization classification, lymph node dissection and concomitant treatment.
Result:The rate of ovarian cancer recurrence is 36.65%.During the uniariate analysis, age, ascites exfoliated cells and pathologic types, lymph node dissection and chemotherapy pecept are unconcerned with the epithelial ovarian cancer recurrence(P>0.05).The clinical stages, residual tumor size, organization classification,the number of the chemotherapy treatment are relevant with the epithelial ovarian cancer recurrence(P<0.05).During the multiariate analysis, the clinical stages, residual tumor size, organization classification and the number of the chemotherapy treatment are independent factors to influence the patients with recurrent( P<0.05).Other factors are no influence to the recurrent tumor.
Conclusion:1. The clinical stages, residual tumor size, organization classification and the number of chemotherapy treatment are relevant factors for epithelial ovarian cancer recurrence.During the multiariate analysis, the clinical stages, residual tumor size, organization classification and the number of chemotherapy treatment are independent factors to influence the patients with recurrent. 2. The later period of the oarian cancer ,the bigger rate of the possibility to recur. Therefore, it is meaningful to improve the prognosis of patients with early diagnosisrate, and decrease the recurrence rate. 3. In patients with adanced oarian cancer, especially the application of combined ascites, neoadjuvant chemotherapy can improve the resection rate, reduce the recurrence rate.4. Age, ascites exfoliated cells ,pathologic types and lymph node dissection and chemotherapy pecept are unconcerned with the epithelial ovarian cancer recurrence.
Ovarian cancer is one of the most common gynecological malignancies,and 85%-90% of patients are epithetlial ovarian cancer. The early diagnosis is hard to make out beacuase the ovarian is located in the deep of the pelvic cavity,and when you discovered the cancer ,70% of the patients have been to the late stage age.After the surgery and chemotherapy treatments, 50%-80% of the patients recur.It leads to the low 5-year survical rate of the ovarian cancer. Many factors related with ovarian cancer recurrence. Therefore, it has positive significance to make indiidual treatments, improve the prognosis of patients with recurrent, delay time and improve patient surial rates by analysising and summaring these factors with ovarian cancer recurrence relationship. At present, many scholars think there are a few of factors is relevant to the recurrent epithelial ovarian.This research mainly from some aspects to analysis the relationship with the recurrent epithelial oarian cancer,such as clinical parameters of oarian cancer (the age, the clinical stages, residual tumor size, ascites) , pathological parameters (pathologic types, organization classification, lymph node dissection) and adjuvant chemotherapy.
Object:Explore the clinical, pathological and adjuvant chemotherapy for I - IV stage solid-cystic-papillary epithelial ovarian cancer patients who have recerived surgery treatment and recur.
Method:Retrospective review of 191 patients from the First Hospital of Jilin University with ovarian carcinoma treated surgically between January 2000 and January 2010, and 70 cases are fit for the standard to diagnose recurrent cancer. Using univariate and multivariate analysis method to discussed the various factors of the recurrent epithelial ovarian cancer,such as the clinical stages age, tumor size, ascites, focal residual pathological type, organization classification, lymph node dissection and concomitant treatment.
Result:The rate of ovarian cancer recurrence is 36.65%.During the uniariate analysis, age, ascites exfoliated cells and pathologic types, lymph node dissection and chemotherapy pecept are unconcerned with the epithelial ovarian cancer recurrence(P>0.05).The clinical stages, residual tumor size, organization classification,the number of the chemotherapy treatment are relevant with the epithelial ovarian cancer recurrence(P<0.05).During the multiariate analysis, the clinical stages, residual tumor size, organization classification and the number of the chemotherapy treatment are independent factors to influence the patients with recurrent( P<0.05).Other factors are no influence to the recurrent tumor.
Conclusion:1. The clinical stages, residual tumor size, organization classification and the number of chemotherapy treatment are relevant factors for epithelial ovarian cancer recurrence.During the multiariate analysis, the clinical stages, residual tumor size, organization classification and the number of chemotherapy treatment are independent factors to influence the patients with recurrent. 2. The later period of the oarian cancer ,the bigger rate of the possibility to recur. Therefore, it is meaningful to improve the prognosis of patients with early diagnosisrate, and decrease the recurrence rate. 3. In patients with adanced oarian cancer, especially the application of combined ascites, neoadjuvant chemotherapy can improve the resection rate, reduce the recurrence rate.4. Age, ascites exfoliated cells ,pathologic types and lymph node dissection and chemotherapy pecept are unconcerned with the epithelial ovarian cancer recurrence.
引文
[1] Boyd J.Molecular genetics of hereditary ovarian caneer.Oncology 1998: 12(3):399-413.
[2] Mori M,Harabuchi I,Miyake H,et al. Reproduetive,genetic and dictary risk factors for ovarian cancer. Am J EPidemiol 1988:128(4):771.
[3] Parazzini f, Franceschi S, Vecchia C, et al.The epidemiology of ovarian caneer.Gynecol Oncol.1991:43:9-23.
[4] Rubin SC, Sabbatini P and Randall ME.Ovarian cancer.Caneer Management: A multidisciplinary approach 1999,Third edition.
[5] Elit L.Familial ovarine cancer. Can Fam Physieian 2001:47:778-784.
[6]燕鑫,陈春玲. 61例复发性上皮性卵巢癌相关临床因素分析[J].中国妇产科临床杂志,2004,5 (5):182.
[7]臧荣余,张志毅,蔡树模,等.晚期卵巢上皮性癌复发的影响及处理因素[J] .中华妇产科杂志,2002 ,37 (9) :546-549.
[8]陈晓军,丰有吉.老年卵巢上皮癌患者的治疗及预后分析[J].现代妇产科进展,2001 ,10 (1) :46-47.
[9]张洁清,李力,陈心秋.卵巢癌治疗后早期复发因素的探讨[J].癌症,2003,22(11):1201-1203.
[10]曹泽毅,于莎莎.妇科恶性肿瘤治疗后一年内未控与复发原因的研究——附全国61所医院1735例分析[J].中华妇产科杂志,1996, 31:417 - 421.
[11] Griffiths CT.Surgical reduction of tumor bulk in the primary treatment of ovarian carcinoma [ J ].National Cancer Institute Monographs, 1975,42:101 - 111.
[12] Eisenkop SM , Friedman RL. Wang HJ. Complete cytoreductive surgery is feasible and maxinizes survival in patients with advanced epithelial ovariancancer: Aprospective study, Gynecol Oncol,1998, 69: 103- 108.
[13] Bristow RE,Tomacruz RS,Armstrong DK,et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era:a meta-analysis[J]. J Clin Oncol,2002,20(4):1248-1259.
[14]徐伟,孙延慰,酆豫增,等.上皮性卵巢癌复发因素分析[J].上海第二医科大学学报, 2001,21:457 - 459.
[15] David M.Primary cytoreduction for advanced epithelial ovarian cancer[J].Obstetrics and Gynecology Clinics of North America ,1994 ,21:121 - 139.
[16] Dupont NC,BermanML.Surgical management of epithelial ovarian cancer:a review of the literature[J].Minerva Ginecol,2004,56(6):547-556.
[17] Lyngstadaas A,Ekanger R,Hagen B.Treatment of primary ovarian cancer:a systematic review[J].Tidsskr Nor Laegeforen,2005,125(3):278-281.
[18] Munkaran AR,Hallum AV,Morris M,et al.Prognostic signify-cance of residual disease in patients with stageⅣepithelial ovarian cancer[J] . Gynecol Oncol ,1997,64:13-17.
[19] Liu PC,Benjamin I,Morgan MR,et al.Effect of surgical debulking on survival in stageⅣovarian cancer [J] . Gynecol Oncol,1997,64:4- 8.
[20]臧荣余,张志毅,陈洁.Ⅳ期卵巢上皮癌肿瘤细胞减灭术及预后因素的临床研究[J].中华妇产科杂志,2000,35:197.
[21]吴鸣,沈铿,郎景和.Ⅳ期卵巢上皮癌的治疗及其预后影响因素[J].中华妇产科杂志,2000,35 :200.
[22] Ngl W,Rubin SC,Hosiins WJ,et al.Aggressive chemosurgial de- bulking in patientswith advanced ovarian cancer[J]. Gynecol Oncol, 1990,38:358.
[23]沈铿,朗景和.卵巢上皮性癌诊断和治疗中应注意的问题[J].中华妇产科杂志, 2003, 38 (2) : 65- 68.
[24]丁晓曼,郎景和.Ⅲ期卵巢上皮癌手术彻底性对预后的影响[J].中国实用妇科与产科杂志, 1999, 15: 105.
[25]连丽娟,主编.林巧稚妇科肿瘤学[M].第2版,北京:人民卫生出版社,2000.
[26] Tay EH,Grant PT,Gebski V,et al.Secondary cytoreductive surgery for recurrent epithelial ovarian cancer.Obstet Gynecol,2002,99(6):1008-1013.
[27] Mutch DG,Surgery for recurrent epithelial ovarian cancer. Sem in Oncol,2002,29(supp1.):3-8
[28] Feldman GB , Knapp RC ,Order SE , et al. The role of lymphatic obstraction in the formation of ascites in a murine ovarina carcinoma.Cancer Res[J],1972,32:1663.
[29]宋水勤,张国楠,吴艳丽,等.中国癌症杂志[J]1999,12(9) :413.
[30] Tentes AA ,Tripsiannis G, Markakidis SK, et al.Peritoneal cancer index:a prognostic indicator of survival in advanced ovarian cancer.Eur J Surg Oncol,2003,29:69-73.
[31] Puls LE,Duniho T,Hunter JE,et al.The prognostic implication of ascites in advanced stage ovarian cancer.Gynecol Oncol,1996 ,61(6):109.
[32] Makar A,Baekelandt M,Trope GC,et al.The prognostic significance of residual disease:FIGO substage,tumor histology and grade in patients with FIGO stageⅢovarian cancer[J].Gyneol Oncol,1995,56 (2) :175-180.
[33] Bolis G,Villa A ,Guarnerio P,et al.Survival of women with advanced ovarian cancer and complete pathologic response at second-look laparotomy. Cancer,1996,77(1):128.
[34] Kosary CL.FIGO stage,histology,histologic grade,age and race as prognostic factors in determining survival for cancers of the female gynecological system:an analysis of 1973～1987 SEER cases of cancers of the endometrium,cervix,ovary,vulva and vagina.Semin Surg Oncol , 1994, 10(1):31.
[35] Colozza M,Mosconi AM,Gori S,et al.Long2term results in patients withadvanced epithelial ovarian carcinoma treated with a combination of cisplatin,doxorubicin,and cyclophosphamide.Am J Clin Oncol,1997,20 (5):552.
[36] Ahmed FY,Wiltshaw E,A′Hern RP,et al.Natural history and prognosis of untreated stageⅠepithelial ovarian carcinoma.J Clin Oncol,1996, 14(11): 2968.
[37] Schilder RJ,Boente MP,Corn BW,et al. The management of early ovarian cancer.Oncology2Huntingt,1995,9 (2):171-182.
[38] Sainz de la Cuesta R,Goff BA,Fuller AF, et al.Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms.Obstet Gynecol,1994,84(1):1-76.
[39] Sliutz G.Prognostic factors in ovarian carcinoma.Wien Med Wochenschr, 1996,146(1～2):149.
[40] Finn CB,Luesley DM,Buxton EJ,et al.Is stageⅠepithelial ovarian cancer overtreated both surgically and systemically.Results of a five year cancer registry review. Br J Obstet Gynaecol,1992,99(1):54.
[41]牛兆园,戴淑真,等.现代妇产科进展[J],2007,4(16):288.
[42]熊宇芳,王泽华.腹膜后淋巴结清除术与卵巢癌的预后[J],国外医学妇产科学分册,2003,30(2):111.
[43] Hoskins WJ.Surgical staging and cytoreductive surgical of epithethlial ovrain cancer.Cancer,1993,71,1534-1550.
[44] Suzuki M,Ohwada M,Yamada T,et al.Lymphnode metastasis in stage I epithelial ovarian cancer[J].Gynecol Oncol,2000, 79(2):305- 308.
[45] Takeshima N,Hirai Y,Umayahara K,et al.Lymphnode metastasis in ovarian cancer: difference between serous and non- serous primary tumors[J].Gynecol Oncol,2005,99(2):427- 431.
[46] Sugiyama T,Kamura T,Kigawa J,et al.Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis andresistance to platinum based chemotherapy[J].Cancer,2000,88(11):2584- 2589.
[47] Mayr D,Diebold J.Grading of ovarian carcinomas[J].Int J Gynecol Pathol,2000, 19(4):348-353.
[48] Arango HA,Hoffman MS,Roberts WS,et al.Accuracy of lymphnode palpation to determine need for lymphadenectomy in gynecologic malignancies[J].Obstet Gynecol,2000,95 (4):553-556.
[49] Brughardt E,Girardi F,L ahousen M,et al.Systemat icpelvic paraaortic lymphade nectomy for advanced ovarian cancer.Gyneco Oncol,1997, 40 (2) : 103-106.
[50] Allen DG,Coulter J.Survival of patients with epithelial ovarian cancer and the effect of lymphade nectomy intho se w ith stage III disease. A ust N ZJ O bstet Gynaeco l,1999, 39 (4) : 420-424.
[51]余冬青,李力.腹膜后淋巴结清扫在卵巢上皮癌治疗中的作用[J].广东医学, 2007, 28 (9) : 1489-1492.
[52]郎景和.I期卵巢癌的淋巴结转移[J].中华妇产科杂志, 1992,27 (4) : 338.
[53]熊宙芳,王泽华,王世宣.卵巢上皮性癌的腹膜后淋巴结切除对预后的影响[J].中华妇产科杂志, 2003, 38 (2):77-80.
[54] Eisenkops SM,Spirtos NM.The clinical significancer of occult macroscopically positive retroperitoneal nodes in patients with ep- ithlial ovarian cancer[J]. Gynecol Oncol , 2001, 82: 143-149.
[55] Agarwal R,Kaye SB.Ovarian cancer:strategies for over-confing resistance to chemotherapy[J].Nat Rev Cancer,2003, 3: 502-516.
[56] Kikkawa F, Ishikawa H,Tamakoshi K, et al. Prognostic evaluation of lymphadenctomy for epithelial ovarian cancer[J]. J Surg Oncol, 1995, 60: 227-231.
[57] Poncheville L,Perrotin F,Lefrancq T,et al.Does paraaotic lymphade-nectomy have a benefit in the treatment of ovarian cancer that is apparently confined to the ovarine?Eur J Cancer,2003,37(2):210-215.
[58] Alettig D,Dowdy SC,Gostout BS,et al. Aggressive surgical effect and improved survival in advanced-stage ovarian cancer[J].Obstet Gynecol , 2006, 107: 77-85.
[59]王文福,孙蕊,马玲,等.晚期卵巢上皮性癌腹膜后淋巴结清除的合理选择[J].中华妇产科杂志, 1999,34 : 108 - 109.
[60]谢小敏.复发卵巢上皮癌的手术及化学治疗[J].广西医学,2007, 29 (8) : 1214-1215.
[61] Searabelli C,Gallo A,Zarrelli A,et al.Systematic pelyic and paraaortic lymphadenectomy during cytoreductive surgery in advanced ovarian cancer:potential benefit on survical.Gynecol Oncol.1995,58(3):417.
[62] Petru E,Lahousen M,Tamussino K,et al.Lymphadenectomy in stage I ovarian cancer.Am J Obstet Gynecol,1994,170(2):656-662.
[63] Onda T,yoshikawa H,Yasogi T,et al.Assessment of metastases to aortic and pelvic lymphnodes in epithelial ovarian cancer.Cancer,1996,78:903-908.
[64] Malfetano JH.The appendix and its metastanic potential of epihelial ovarian cancer.Obstat Gynecol.1987;69;369.
[65]高永良主编.妇科恶性肿瘤[M].杭州:浙江科学技术出版社,1985,94.
[66]邵敬聆,等.妇科手术同时切除阑尾527例分析[J].中华妇产科杂志,1987:22(3):141.
[67] Mc Vay JR,Hager WD.The appendix in relation to neoplastic disease.Cancer,1964:17:929.
[68]李艳芳,李孟达.卵巢恶性肿瘤的阑尾转移[J].中国实用妇科与产科杂志,1996,11(6):349.
[69] Menck HK,Garfinkel L,Dodd GD.Preliminary report of the national cancer date base[J].Cancer J Clin, 1991, 41: 7.
[70] Ozols RF, Yong RC. Chem therapy of ovarian cancer[J]. Sem inOncol,1991, 18: 222.
[71] Griffiths CT.Fuller AF.Intensive surgical and chemotherapcutic management of advanced ovarian cancer. Chn Surg North America,1978 , 58 :131-142.
[72] Delcayre A,Le Pecq JB.Exosomes as novel therapeutic nanodevices[J]. Curr Opin Mol Ther,2006,8(1):31- 38.
[73]狄晓鸿.伴有腹水和血清CA- 125抗原升高的9例卵巢良性肿块临床分析[J].卫生职业教育,2006(18).
[74] Hegazy MA,Hegazi RA,Elshafei MA,et al.Neoad juoant chemotherapy versus primary surgery in advanced ovarian carcinoma. World J Surg Oncol ,2005,3 :57-64.
[75] Loizzi V,Cormio G,Resta L ,et al.Neoadjuvant chemotherapy in advanced ovarian cancer a case control study. Int J Gynecol Cancer ,2005 ,15 :217-223.
[76] Ansquer Y, Leblanc E,Clough K, et al.Neoadjuvant chemotherapy for unresectable ovarian carcinoma:a French multicenter study. Cancer ,2001 , 91 :2329-2334.
[77] Ushijima K,Ota S,Komai K,et al.Clinical assessment of neoadjuvant chemotherapy and interval cytoreductive surgery for unresectable advanced ovarian cancer. Int Surg ,2002 ,87 :185-190.
[78] Le T,Alshaikh G,Hopkins L,et al.Prognostic significance of postoperative morbidities in patientswith advanced epthielial ovarian cancer treated with neoadjuvant chemotherapy and delayed primary surgical debulking[J]. Ann Surg Oncol, 2006, 13 ( 12 ) : 1711 -1716.
[79] Vergote I , de Wever I , Decloedt J , et al . Neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer. Semin Oncol ,2000 ,27 :3 ,1-36.
[80] McCluggage WG,Lyness RW,et al.Morphological effects of chemo- therapy on ovarian carcinoma .J clin Pathol,2002,55:27- 31.
[81] Kuhn W, Rutke S,Spathe K,et al.Neoadjuvant chemotherapy followed by tumor debulking prolongs survival for patients with poor prognosis in International Federation of Gynecology and Obstetrics Stage IIIc ovarian carcinoma. Cancer ,2001 ,92 :2585-2591.
[82] Lee SJ, Kim BG, Lee JW, et al. Preliminary results of neoadjuvant chemotherapy with paclitaxel and cisp latin in patientswith advanced epithelial ovarian cancer who are inadequate for op timum p rimary surgery[ J ]. J Obstet Gynaecol Res, 2006, 32 (1) : 99 - 106.
[83] PectasidesD, FarmakisD, Koumarianou A. The role of neoadjuvant chemotherapy in the treatment of advanced ovarian cancer [J].Oncology, 2005, 68 (1) : 64 - 70.
[84] Le T, Faught W, Hopkins L, et al. Primary chemotherapy and adjuvant tumor debulking in the management of advanced-stage epithelial ovarian cancer[ J ]. Int J Gynecol Cancer, 2005, 15 (5) :770 - 775.
[85]李巍,崔恒,冯捷,李艺.卵巢癌诊断的研究进展[J].中华妇产科杂志,2005(7).
[86]赵营,等.紫杉醇作为一线药物在卵巢癌化疗中的应用[J].国际医药卫生导报,2007,13(15):101- 104.
[87] Trope C, Kaern J. Paclitaxel in untreated FIGO stage III suboptimally resected ovarian cancer[J]. Ann Oncol, 1997, 8: 803- 806.
[88]蒋静,唐良萏,等.基因与卵巢癌耐药的关系[J].实用医学杂志,2007,(10):155- 157.
[89] Mc Guire WP,Hoekins WJ,BradyMF,et al.Comparisin of combination therapy with paclitaxel and cisplatin versus cyclophosphamide and cisplatin in patients with suboptimal stage III and stage IV ovarian cancer[J]. Semin Oncol, 1997, 24(sipple 2): 13- 16.
[90]刘伟,李苏宜.卵巢癌化疗新进展[J].肿瘤基础与临床, 2006, 19(6) : 526 - 528.
[91] Poveda A. Remarks and conclusions on ovarian cancer treatment[J].Int J Gynecol Cancer, 2001, 11(Suppl 1): 77-81.
[92] Ezcurdia L, Jovtis S L. Paclitaxel in platinum - resistant ovarian cancer patients. Argentine Multicenter Taxol Group [J].Semin Oncol,1997,24(suppl 15): 53- 56.
[93] Markman K, Hakes T, Reichman B, et al. Ifosfamide and mensa in previously treated advanced epithelial ovarian cancer activity in platinum-resistant disease[J].J Clin Oncol, 1992, 10: 243.
[94] Ten Bokkel Huinink W,Lane SR,Ross GA,et al.Long-term survival in a phase III, randomised study of topotecan versus paclitaxel in advanced epithelial ovarian carcinoma[J]. Ann Oncol,2004,15(1):100-103.
[95] Mutch DG, Orlando M, Goss T, et al. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer[J].J Clin Oncol, 2007,25(19): 2811-2818.
[96] Choan C ,Quon M,Gallant V ,et al . Effective palliative radiotherapy for symp-tomatic recurrent or residual ovarian cancer. Gynccol Oncol ,2006 ,102 :204-209.
[97] Zylberbery B, Ravine JH, Salat-broux J, et al. Chemotherapy by the intravenous and intraperitoneal routes combined in ovarian cancer[J]. Gynecol Oncol, 1997, 65: 164.
[98]柳英兰,韩旭,徐柏,等.含紫杉醇类和卡铂的不同方案治疗卵巢癌临床分析[ J ].现代肿瘤医学, 2007, 15 (12) : 1831 - 1833.
[99]郎景和.卵巢恶性肿瘤诊断与治疗策略的建议[J].中华妇产科杂志,1995 ,30 (9) :569.
[100] Kong G, Braun RD, DewhirstMW. Characterization of the effect of hyperthermia on nanoparticle extravasation from tumor vasculature [J]. Cancer Res, 2001, 61 (7) : 3027 - 3032.
[101]吴鸣,沈铿,郎景和.Ⅳ期卵巢上皮癌的治疗及其预后影响因素[J] .中华妇产科杂志,2000 ,35 :200.
[102]邢军,霄永红.卵巢上皮性癌生存与预后临床分析[J].河北医学,1999,5(2):3-5.
[103] Bertalsen KA.Prospective randomized comparison of 6 and 12 cycles of cyclophosphamide adiramycin and ciplatin in advanced epithelia ovarian cancer:A Danish ovarian study group trial(DACOVA)[J].Gynecol Oncol,1993,49:30.
[104]刘穗,刘继红,黄鹤,等.上皮性卵巢癌复发的影响因素分析[J].癌症,2003,11.
[105] Kapp KS,Kapp DS,PoschaukoJ,et al.The prognostic significance of peritoneal seeding and size of post surgical residual inpatients with stageⅢepithelial ovarian cancer treated with surgery,chemotherapy,and high dose radiotherapy. Gynecol Oncol,1999m74: 400-407.
[106] Igor B, Borut G. Preperative value of CA125 as a reflection of tumor grade in ep itheliai ovarian cancer. Gynecal Oncal. 1996, 63: 166.
[107]王自正.现代医学标记免疫学[M] .北京:人民军医出版社,2000: 60.
[108]梁雪芳,李燕钰.CA125对卵巢恶性肿瘤诊断价值的评价[J].中华肿瘤防治杂志, 2006, 13 (10) : 762– 780.
[109] Friedlander ML.Prognostic factors in ovarian cancer.Semin Oncol.1998, 25: 305.
[110]高水良.妇科肿瘤标志物的研究进展[J].中国实用妇科与产科杂志, 2000. 16 (6) : 374– 376.
[111] Goonetilleke KS,Siriwardena AK.Systematic review of carbohydrate antigen (CA 19-9) as a biochemicalmarker in the diagnosis ofpancre-atic cancer. Eur J SurgOnco.l 2007, 33: 266.
[112] Sasaki A, Kawano K, Inomata M,et al. Value ofserum carbohydrate antigen 19-9 for predicting extrahepaticmetastasis in patientswith liver metastasis from colorectal carcinoma. Hepatogastroenterology. 2005,52:1814.
[113] Gadducci A , Feroleghihi M ,Prontera C,et al . The Concomitant determination of different tumor markers in patients with epithelial ovarian cancer and benign ovarian masses : relevance for differential diagnosis[J].Gynecol Onco1, 1992, 44(1):147-154.
[114] Rubin SC,Hoskins WJ,Saigo PE,et al.Prognostic factors for recurrence following negative second—look laparoctomy in ovarian cancer patients treated with platinum—based chemotherapy[J].Gynecol Oncol, 1991,42(2):137-141.
[115]杨静华,冯莉,李丽,等.OPN、CA125和CA199检测对卵巢上皮癌诊断和预后的价值[J].中国计划生育学杂志,2007,15(12):740-742.
[116]孙荣武,王鸿利,主编.临床实验诊断学[M].第1版.上海:上海科学技术出版社. 2001, 448.
[117] Jaeger W,Ackermann S,KesslerH, et al.The effect of bowel resec-tion on survival in advance epithelial ovarian cancer. Gynecol Oncol.2001, 83 (6) : 286.
[118]张洁,张志毅.102例卵巢癌肠道转移的手术疗效分析[J].中国癌症杂志. 2000, 10 (2) : 124.
[119]尹伯元.放射免疫分析在医学中的应用[M].第1版1北京:原子能出版社. 1991, 132.
[120] Verma S,Li SH,Badiwada MV,et al.Endothelin antagoniam and interleukin-6 inhibition attenuate the proatherogenie effects of creactive protein[J].Circulation,2002,105(16):1890-1896.
[121] Fioretti P , Gaddueei A , Ferdeghini M , et al.The concomitant determination of different serum tumor markers in epithelial ovarian cancer: relevance for monitoring the response to chemotherapy and follow-up of patients[J].Gynecol Oncol, 1992,44(2):155-160.
[122]佘剑英,李菁.血清CA125、CA199在卵巢浆、粘液性囊腺癌术前诊断价值[J].中国医师杂志,2004,6(10):1425-1426.
[123]万文徽.肿瘤标志物临床应用中的若干问题[J].中华检验医学杂志. 2000, 23: 9.
[124] Ravank K,Jarvinen K,Paasinen-Sohns A,et al.Loss of p27 kip 1 from cyclin E/CDKI but not from cyclin kl/CDK4,complexes in cells transformed by polyamine biosynthtetic enzymes.Caneer Res,2000,60(18):5244-5353.
[125] Maseiullo V,Sgambato A,Paciho C,et al.Cancer Res.1999,59(15): 3790-3794.
[126] Kim K,Shim J,Kim J.Overexpression of p21,cyclin E anddecreased expression of p27 in DMBA(7,12-dimethylbenzan thracene).induced rat ovarian careinogenesis. Pathol Int,2003,53(5):291-296.
[127] Bali A,O’Brien P,Edwards L,et al.Cyclin DI,p53,and p21 Wafl/Cipl expression is predietive of poor clinieal outcome in serousepithelial ovarian cancer. Clin Cancer Res,2004,10(15):5168-5177.
[128] Schmider-Ross A,Pirsig O,Gottsehalk E,et al.Cyclin一dependent kinase inhibitors CIP1 (p21) and KIpl (p27) in ovarian cancer. Cancer Res Clin Oncol.,2006,132(3):163-170.
[2] Mori M,Harabuchi I,Miyake H,et al. Reproduetive,genetic and dictary risk factors for ovarian cancer. Am J EPidemiol 1988:128(4):771.
[3] Parazzini f, Franceschi S, Vecchia C, et al.The epidemiology of ovarian caneer.Gynecol Oncol.1991:43:9-23.
[4] Rubin SC, Sabbatini P and Randall ME.Ovarian cancer.Caneer Management: A multidisciplinary approach 1999,Third edition.
[5] Elit L.Familial ovarine cancer. Can Fam Physieian 2001:47:778-784.
[6]燕鑫,陈春玲. 61例复发性上皮性卵巢癌相关临床因素分析[J].中国妇产科临床杂志,2004,5 (5):182.
[7]臧荣余,张志毅,蔡树模,等.晚期卵巢上皮性癌复发的影响及处理因素[J] .中华妇产科杂志,2002 ,37 (9) :546-549.
[8]陈晓军,丰有吉.老年卵巢上皮癌患者的治疗及预后分析[J].现代妇产科进展,2001 ,10 (1) :46-47.
[9]张洁清,李力,陈心秋.卵巢癌治疗后早期复发因素的探讨[J].癌症,2003,22(11):1201-1203.
[10]曹泽毅,于莎莎.妇科恶性肿瘤治疗后一年内未控与复发原因的研究——附全国61所医院1735例分析[J].中华妇产科杂志,1996, 31:417 - 421.
[11] Griffiths CT.Surgical reduction of tumor bulk in the primary treatment of ovarian carcinoma [ J ].National Cancer Institute Monographs, 1975,42:101 - 111.
[12] Eisenkop SM , Friedman RL. Wang HJ. Complete cytoreductive surgery is feasible and maxinizes survival in patients with advanced epithelial ovariancancer: Aprospective study, Gynecol Oncol,1998, 69: 103- 108.
[13] Bristow RE,Tomacruz RS,Armstrong DK,et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era:a meta-analysis[J]. J Clin Oncol,2002,20(4):1248-1259.
[14]徐伟,孙延慰,酆豫增,等.上皮性卵巢癌复发因素分析[J].上海第二医科大学学报, 2001,21:457 - 459.
[15] David M.Primary cytoreduction for advanced epithelial ovarian cancer[J].Obstetrics and Gynecology Clinics of North America ,1994 ,21:121 - 139.
[16] Dupont NC,BermanML.Surgical management of epithelial ovarian cancer:a review of the literature[J].Minerva Ginecol,2004,56(6):547-556.
[17] Lyngstadaas A,Ekanger R,Hagen B.Treatment of primary ovarian cancer:a systematic review[J].Tidsskr Nor Laegeforen,2005,125(3):278-281.
[18] Munkaran AR,Hallum AV,Morris M,et al.Prognostic signify-cance of residual disease in patients with stageⅣepithelial ovarian cancer[J] . Gynecol Oncol ,1997,64:13-17.
[19] Liu PC,Benjamin I,Morgan MR,et al.Effect of surgical debulking on survival in stageⅣovarian cancer [J] . Gynecol Oncol,1997,64:4- 8.
[20]臧荣余,张志毅,陈洁.Ⅳ期卵巢上皮癌肿瘤细胞减灭术及预后因素的临床研究[J].中华妇产科杂志,2000,35:197.
[21]吴鸣,沈铿,郎景和.Ⅳ期卵巢上皮癌的治疗及其预后影响因素[J].中华妇产科杂志,2000,35 :200.
[22] Ngl W,Rubin SC,Hosiins WJ,et al.Aggressive chemosurgial de- bulking in patientswith advanced ovarian cancer[J]. Gynecol Oncol, 1990,38:358.
[23]沈铿,朗景和.卵巢上皮性癌诊断和治疗中应注意的问题[J].中华妇产科杂志, 2003, 38 (2) : 65- 68.
[24]丁晓曼,郎景和.Ⅲ期卵巢上皮癌手术彻底性对预后的影响[J].中国实用妇科与产科杂志, 1999, 15: 105.
[25]连丽娟,主编.林巧稚妇科肿瘤学[M].第2版,北京:人民卫生出版社,2000.
[26] Tay EH,Grant PT,Gebski V,et al.Secondary cytoreductive surgery for recurrent epithelial ovarian cancer.Obstet Gynecol,2002,99(6):1008-1013.
[27] Mutch DG,Surgery for recurrent epithelial ovarian cancer. Sem in Oncol,2002,29(supp1.):3-8
[28] Feldman GB , Knapp RC ,Order SE , et al. The role of lymphatic obstraction in the formation of ascites in a murine ovarina carcinoma.Cancer Res[J],1972,32:1663.
[29]宋水勤,张国楠,吴艳丽,等.中国癌症杂志[J]1999,12(9) :413.
[30] Tentes AA ,Tripsiannis G, Markakidis SK, et al.Peritoneal cancer index:a prognostic indicator of survival in advanced ovarian cancer.Eur J Surg Oncol,2003,29:69-73.
[31] Puls LE,Duniho T,Hunter JE,et al.The prognostic implication of ascites in advanced stage ovarian cancer.Gynecol Oncol,1996 ,61(6):109.
[32] Makar A,Baekelandt M,Trope GC,et al.The prognostic significance of residual disease:FIGO substage,tumor histology and grade in patients with FIGO stageⅢovarian cancer[J].Gyneol Oncol,1995,56 (2) :175-180.
[33] Bolis G,Villa A ,Guarnerio P,et al.Survival of women with advanced ovarian cancer and complete pathologic response at second-look laparotomy. Cancer,1996,77(1):128.
[34] Kosary CL.FIGO stage,histology,histologic grade,age and race as prognostic factors in determining survival for cancers of the female gynecological system:an analysis of 1973～1987 SEER cases of cancers of the endometrium,cervix,ovary,vulva and vagina.Semin Surg Oncol , 1994, 10(1):31.
[35] Colozza M,Mosconi AM,Gori S,et al.Long2term results in patients withadvanced epithelial ovarian carcinoma treated with a combination of cisplatin,doxorubicin,and cyclophosphamide.Am J Clin Oncol,1997,20 (5):552.
[36] Ahmed FY,Wiltshaw E,A′Hern RP,et al.Natural history and prognosis of untreated stageⅠepithelial ovarian carcinoma.J Clin Oncol,1996, 14(11): 2968.
[37] Schilder RJ,Boente MP,Corn BW,et al. The management of early ovarian cancer.Oncology2Huntingt,1995,9 (2):171-182.
[38] Sainz de la Cuesta R,Goff BA,Fuller AF, et al.Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms.Obstet Gynecol,1994,84(1):1-76.
[39] Sliutz G.Prognostic factors in ovarian carcinoma.Wien Med Wochenschr, 1996,146(1～2):149.
[40] Finn CB,Luesley DM,Buxton EJ,et al.Is stageⅠepithelial ovarian cancer overtreated both surgically and systemically.Results of a five year cancer registry review. Br J Obstet Gynaecol,1992,99(1):54.
[41]牛兆园,戴淑真,等.现代妇产科进展[J],2007,4(16):288.
[42]熊宇芳,王泽华.腹膜后淋巴结清除术与卵巢癌的预后[J],国外医学妇产科学分册,2003,30(2):111.
[43] Hoskins WJ.Surgical staging and cytoreductive surgical of epithethlial ovrain cancer.Cancer,1993,71,1534-1550.
[44] Suzuki M,Ohwada M,Yamada T,et al.Lymphnode metastasis in stage I epithelial ovarian cancer[J].Gynecol Oncol,2000, 79(2):305- 308.
[45] Takeshima N,Hirai Y,Umayahara K,et al.Lymphnode metastasis in ovarian cancer: difference between serous and non- serous primary tumors[J].Gynecol Oncol,2005,99(2):427- 431.
[46] Sugiyama T,Kamura T,Kigawa J,et al.Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis andresistance to platinum based chemotherapy[J].Cancer,2000,88(11):2584- 2589.
[47] Mayr D,Diebold J.Grading of ovarian carcinomas[J].Int J Gynecol Pathol,2000, 19(4):348-353.
[48] Arango HA,Hoffman MS,Roberts WS,et al.Accuracy of lymphnode palpation to determine need for lymphadenectomy in gynecologic malignancies[J].Obstet Gynecol,2000,95 (4):553-556.
[49] Brughardt E,Girardi F,L ahousen M,et al.Systemat icpelvic paraaortic lymphade nectomy for advanced ovarian cancer.Gyneco Oncol,1997, 40 (2) : 103-106.
[50] Allen DG,Coulter J.Survival of patients with epithelial ovarian cancer and the effect of lymphade nectomy intho se w ith stage III disease. A ust N ZJ O bstet Gynaeco l,1999, 39 (4) : 420-424.
[51]余冬青,李力.腹膜后淋巴结清扫在卵巢上皮癌治疗中的作用[J].广东医学, 2007, 28 (9) : 1489-1492.
[52]郎景和.I期卵巢癌的淋巴结转移[J].中华妇产科杂志, 1992,27 (4) : 338.
[53]熊宙芳,王泽华,王世宣.卵巢上皮性癌的腹膜后淋巴结切除对预后的影响[J].中华妇产科杂志, 2003, 38 (2):77-80.
[54] Eisenkops SM,Spirtos NM.The clinical significancer of occult macroscopically positive retroperitoneal nodes in patients with ep- ithlial ovarian cancer[J]. Gynecol Oncol , 2001, 82: 143-149.
[55] Agarwal R,Kaye SB.Ovarian cancer:strategies for over-confing resistance to chemotherapy[J].Nat Rev Cancer,2003, 3: 502-516.
[56] Kikkawa F, Ishikawa H,Tamakoshi K, et al. Prognostic evaluation of lymphadenctomy for epithelial ovarian cancer[J]. J Surg Oncol, 1995, 60: 227-231.
[57] Poncheville L,Perrotin F,Lefrancq T,et al.Does paraaotic lymphade-nectomy have a benefit in the treatment of ovarian cancer that is apparently confined to the ovarine?Eur J Cancer,2003,37(2):210-215.
[58] Alettig D,Dowdy SC,Gostout BS,et al. Aggressive surgical effect and improved survival in advanced-stage ovarian cancer[J].Obstet Gynecol , 2006, 107: 77-85.
[59]王文福,孙蕊,马玲,等.晚期卵巢上皮性癌腹膜后淋巴结清除的合理选择[J].中华妇产科杂志, 1999,34 : 108 - 109.
[60]谢小敏.复发卵巢上皮癌的手术及化学治疗[J].广西医学,2007, 29 (8) : 1214-1215.
[61] Searabelli C,Gallo A,Zarrelli A,et al.Systematic pelyic and paraaortic lymphadenectomy during cytoreductive surgery in advanced ovarian cancer:potential benefit on survical.Gynecol Oncol.1995,58(3):417.
[62] Petru E,Lahousen M,Tamussino K,et al.Lymphadenectomy in stage I ovarian cancer.Am J Obstet Gynecol,1994,170(2):656-662.
[63] Onda T,yoshikawa H,Yasogi T,et al.Assessment of metastases to aortic and pelvic lymphnodes in epithelial ovarian cancer.Cancer,1996,78:903-908.
[64] Malfetano JH.The appendix and its metastanic potential of epihelial ovarian cancer.Obstat Gynecol.1987;69;369.
[65]高永良主编.妇科恶性肿瘤[M].杭州:浙江科学技术出版社,1985,94.
[66]邵敬聆,等.妇科手术同时切除阑尾527例分析[J].中华妇产科杂志,1987:22(3):141.
[67] Mc Vay JR,Hager WD.The appendix in relation to neoplastic disease.Cancer,1964:17:929.
[68]李艳芳,李孟达.卵巢恶性肿瘤的阑尾转移[J].中国实用妇科与产科杂志,1996,11(6):349.
[69] Menck HK,Garfinkel L,Dodd GD.Preliminary report of the national cancer date base[J].Cancer J Clin, 1991, 41: 7.
[70] Ozols RF, Yong RC. Chem therapy of ovarian cancer[J]. Sem inOncol,1991, 18: 222.
[71] Griffiths CT.Fuller AF.Intensive surgical and chemotherapcutic management of advanced ovarian cancer. Chn Surg North America,1978 , 58 :131-142.
[72] Delcayre A,Le Pecq JB.Exosomes as novel therapeutic nanodevices[J]. Curr Opin Mol Ther,2006,8(1):31- 38.
[73]狄晓鸿.伴有腹水和血清CA- 125抗原升高的9例卵巢良性肿块临床分析[J].卫生职业教育,2006(18).
[74] Hegazy MA,Hegazi RA,Elshafei MA,et al.Neoad juoant chemotherapy versus primary surgery in advanced ovarian carcinoma. World J Surg Oncol ,2005,3 :57-64.
[75] Loizzi V,Cormio G,Resta L ,et al.Neoadjuvant chemotherapy in advanced ovarian cancer a case control study. Int J Gynecol Cancer ,2005 ,15 :217-223.
[76] Ansquer Y, Leblanc E,Clough K, et al.Neoadjuvant chemotherapy for unresectable ovarian carcinoma:a French multicenter study. Cancer ,2001 , 91 :2329-2334.
[77] Ushijima K,Ota S,Komai K,et al.Clinical assessment of neoadjuvant chemotherapy and interval cytoreductive surgery for unresectable advanced ovarian cancer. Int Surg ,2002 ,87 :185-190.
[78] Le T,Alshaikh G,Hopkins L,et al.Prognostic significance of postoperative morbidities in patientswith advanced epthielial ovarian cancer treated with neoadjuvant chemotherapy and delayed primary surgical debulking[J]. Ann Surg Oncol, 2006, 13 ( 12 ) : 1711 -1716.
[79] Vergote I , de Wever I , Decloedt J , et al . Neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer. Semin Oncol ,2000 ,27 :3 ,1-36.
[80] McCluggage WG,Lyness RW,et al.Morphological effects of chemo- therapy on ovarian carcinoma .J clin Pathol,2002,55:27- 31.
[81] Kuhn W, Rutke S,Spathe K,et al.Neoadjuvant chemotherapy followed by tumor debulking prolongs survival for patients with poor prognosis in International Federation of Gynecology and Obstetrics Stage IIIc ovarian carcinoma. Cancer ,2001 ,92 :2585-2591.
[82] Lee SJ, Kim BG, Lee JW, et al. Preliminary results of neoadjuvant chemotherapy with paclitaxel and cisp latin in patientswith advanced epithelial ovarian cancer who are inadequate for op timum p rimary surgery[ J ]. J Obstet Gynaecol Res, 2006, 32 (1) : 99 - 106.
[83] PectasidesD, FarmakisD, Koumarianou A. The role of neoadjuvant chemotherapy in the treatment of advanced ovarian cancer [J].Oncology, 2005, 68 (1) : 64 - 70.
[84] Le T, Faught W, Hopkins L, et al. Primary chemotherapy and adjuvant tumor debulking in the management of advanced-stage epithelial ovarian cancer[ J ]. Int J Gynecol Cancer, 2005, 15 (5) :770 - 775.
[85]李巍,崔恒,冯捷,李艺.卵巢癌诊断的研究进展[J].中华妇产科杂志,2005(7).
[86]赵营,等.紫杉醇作为一线药物在卵巢癌化疗中的应用[J].国际医药卫生导报,2007,13(15):101- 104.
[87] Trope C, Kaern J. Paclitaxel in untreated FIGO stage III suboptimally resected ovarian cancer[J]. Ann Oncol, 1997, 8: 803- 806.
[88]蒋静,唐良萏,等.基因与卵巢癌耐药的关系[J].实用医学杂志,2007,(10):155- 157.
[89] Mc Guire WP,Hoekins WJ,BradyMF,et al.Comparisin of combination therapy with paclitaxel and cisplatin versus cyclophosphamide and cisplatin in patients with suboptimal stage III and stage IV ovarian cancer[J]. Semin Oncol, 1997, 24(sipple 2): 13- 16.
[90]刘伟,李苏宜.卵巢癌化疗新进展[J].肿瘤基础与临床, 2006, 19(6) : 526 - 528.
[91] Poveda A. Remarks and conclusions on ovarian cancer treatment[J].Int J Gynecol Cancer, 2001, 11(Suppl 1): 77-81.
[92] Ezcurdia L, Jovtis S L. Paclitaxel in platinum - resistant ovarian cancer patients. Argentine Multicenter Taxol Group [J].Semin Oncol,1997,24(suppl 15): 53- 56.
[93] Markman K, Hakes T, Reichman B, et al. Ifosfamide and mensa in previously treated advanced epithelial ovarian cancer activity in platinum-resistant disease[J].J Clin Oncol, 1992, 10: 243.
[94] Ten Bokkel Huinink W,Lane SR,Ross GA,et al.Long-term survival in a phase III, randomised study of topotecan versus paclitaxel in advanced epithelial ovarian carcinoma[J]. Ann Oncol,2004,15(1):100-103.
[95] Mutch DG, Orlando M, Goss T, et al. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer[J].J Clin Oncol, 2007,25(19): 2811-2818.
[96] Choan C ,Quon M,Gallant V ,et al . Effective palliative radiotherapy for symp-tomatic recurrent or residual ovarian cancer. Gynccol Oncol ,2006 ,102 :204-209.
[97] Zylberbery B, Ravine JH, Salat-broux J, et al. Chemotherapy by the intravenous and intraperitoneal routes combined in ovarian cancer[J]. Gynecol Oncol, 1997, 65: 164.
[98]柳英兰,韩旭,徐柏,等.含紫杉醇类和卡铂的不同方案治疗卵巢癌临床分析[ J ].现代肿瘤医学, 2007, 15 (12) : 1831 - 1833.
[99]郎景和.卵巢恶性肿瘤诊断与治疗策略的建议[J].中华妇产科杂志,1995 ,30 (9) :569.
[100] Kong G, Braun RD, DewhirstMW. Characterization of the effect of hyperthermia on nanoparticle extravasation from tumor vasculature [J]. Cancer Res, 2001, 61 (7) : 3027 - 3032.
[101]吴鸣,沈铿,郎景和.Ⅳ期卵巢上皮癌的治疗及其预后影响因素[J] .中华妇产科杂志,2000 ,35 :200.
[102]邢军,霄永红.卵巢上皮性癌生存与预后临床分析[J].河北医学,1999,5(2):3-5.
[103] Bertalsen KA.Prospective randomized comparison of 6 and 12 cycles of cyclophosphamide adiramycin and ciplatin in advanced epithelia ovarian cancer:A Danish ovarian study group trial(DACOVA)[J].Gynecol Oncol,1993,49:30.
[104]刘穗,刘继红,黄鹤,等.上皮性卵巢癌复发的影响因素分析[J].癌症,2003,11.
[105] Kapp KS,Kapp DS,PoschaukoJ,et al.The prognostic significance of peritoneal seeding and size of post surgical residual inpatients with stageⅢepithelial ovarian cancer treated with surgery,chemotherapy,and high dose radiotherapy. Gynecol Oncol,1999m74: 400-407.
[106] Igor B, Borut G. Preperative value of CA125 as a reflection of tumor grade in ep itheliai ovarian cancer. Gynecal Oncal. 1996, 63: 166.
[107]王自正.现代医学标记免疫学[M] .北京:人民军医出版社,2000: 60.
[108]梁雪芳,李燕钰.CA125对卵巢恶性肿瘤诊断价值的评价[J].中华肿瘤防治杂志, 2006, 13 (10) : 762– 780.
[109] Friedlander ML.Prognostic factors in ovarian cancer.Semin Oncol.1998, 25: 305.
[110]高水良.妇科肿瘤标志物的研究进展[J].中国实用妇科与产科杂志, 2000. 16 (6) : 374– 376.
[111] Goonetilleke KS,Siriwardena AK.Systematic review of carbohydrate antigen (CA 19-9) as a biochemicalmarker in the diagnosis ofpancre-atic cancer. Eur J SurgOnco.l 2007, 33: 266.
[112] Sasaki A, Kawano K, Inomata M,et al. Value ofserum carbohydrate antigen 19-9 for predicting extrahepaticmetastasis in patientswith liver metastasis from colorectal carcinoma. Hepatogastroenterology. 2005,52:1814.
[113] Gadducci A , Feroleghihi M ,Prontera C,et al . The Concomitant determination of different tumor markers in patients with epithelial ovarian cancer and benign ovarian masses : relevance for differential diagnosis[J].Gynecol Onco1, 1992, 44(1):147-154.
[114] Rubin SC,Hoskins WJ,Saigo PE,et al.Prognostic factors for recurrence following negative second—look laparoctomy in ovarian cancer patients treated with platinum—based chemotherapy[J].Gynecol Oncol, 1991,42(2):137-141.
[115]杨静华,冯莉,李丽,等.OPN、CA125和CA199检测对卵巢上皮癌诊断和预后的价值[J].中国计划生育学杂志,2007,15(12):740-742.
[116]孙荣武,王鸿利,主编.临床实验诊断学[M].第1版.上海:上海科学技术出版社. 2001, 448.
[117] Jaeger W,Ackermann S,KesslerH, et al.The effect of bowel resec-tion on survival in advance epithelial ovarian cancer. Gynecol Oncol.2001, 83 (6) : 286.
[118]张洁,张志毅.102例卵巢癌肠道转移的手术疗效分析[J].中国癌症杂志. 2000, 10 (2) : 124.
[119]尹伯元.放射免疫分析在医学中的应用[M].第1版1北京:原子能出版社. 1991, 132.
[120] Verma S,Li SH,Badiwada MV,et al.Endothelin antagoniam and interleukin-6 inhibition attenuate the proatherogenie effects of creactive protein[J].Circulation,2002,105(16):1890-1896.
[121] Fioretti P , Gaddueei A , Ferdeghini M , et al.The concomitant determination of different serum tumor markers in epithelial ovarian cancer: relevance for monitoring the response to chemotherapy and follow-up of patients[J].Gynecol Oncol, 1992,44(2):155-160.
[122]佘剑英,李菁.血清CA125、CA199在卵巢浆、粘液性囊腺癌术前诊断价值[J].中国医师杂志,2004,6(10):1425-1426.
[123]万文徽.肿瘤标志物临床应用中的若干问题[J].中华检验医学杂志. 2000, 23: 9.
[124] Ravank K,Jarvinen K,Paasinen-Sohns A,et al.Loss of p27 kip 1 from cyclin E/CDKI but not from cyclin kl/CDK4,complexes in cells transformed by polyamine biosynthtetic enzymes.Caneer Res,2000,60(18):5244-5353.
[125] Maseiullo V,Sgambato A,Paciho C,et al.Cancer Res.1999,59(15): 3790-3794.
[126] Kim K,Shim J,Kim J.Overexpression of p21,cyclin E anddecreased expression of p27 in DMBA(7,12-dimethylbenzan thracene).induced rat ovarian careinogenesis. Pathol Int,2003,53(5):291-296.
[127] Bali A,O’Brien P,Edwards L,et al.Cyclin DI,p53,and p21 Wafl/Cipl expression is predietive of poor clinieal outcome in serousepithelial ovarian cancer. Clin Cancer Res,2004,10(15):5168-5177.
[128] Schmider-Ross A,Pirsig O,Gottsehalk E,et al.Cyclin一dependent kinase inhibitors CIP1 (p21) and KIpl (p27) in ovarian cancer. Cancer Res Clin Oncol.,2006,132(3):163-170.