卵巢癌患者发病危险因素及术后康复效果影响因素分析
摘要
目的对卵巢癌患者发病的危险因素和治疗后康复效果的影响因素进行相关分析,从而为卵巢癌的预防和治疗提供一定的依据。方法选取我院2013年1月至2017年1月收治的358例卵巢癌患者作为观察组,选取同阶段在我院门诊确诊为非恶性肿瘤的女性患者358例作为对照组,收集两组患者的年龄、婚姻状况、民族分布、既往病史、妊娠史、流产史等一般临床资料和相关资料,采用病例对照研究、方差分析、单因素分析和多元回归分析等方法对其进行统计分析,探讨影响卵巢癌患者发病的危险因素。结果病例比较结果显示,卵巢癌的发病与年龄、婚姻状况和民族分布无关;单因素分析结果显示,卵巢癌发病的危险因素有初潮年龄、自然流产、人工流产、月经期、痛经、妊娠次数;多因素分析结果显示,卵巢癌发病的主要危险因素为人工流产(OR=2.3 61,P=0.002)、自然流产(OR=2.197,P<0.001)和月经期(OR=3.413,P<0.001)。Cox风险回归模型的分析结果显示,卵巢癌术后康复效果主要与FIGO分期、术后残存病灶大小和CA_(125)下降水平有关(P<0.05),与年龄、组织学分型和分化程度无关(P>0.05)。结论通过对卵巢癌的发病危险因素和术后康复效果的影响因素进行分析,采取相应的改善措施,一方面预防卵巢癌的发生,另一方面改善已经发生卵巢癌的患者的预后。
引文
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[2] Lynch HT,Casey MJ,Snyder CL,et al.Hereditary ovarian cancer:molecular gen etics,pathology,management,and heterogeneity.Mol Oncol,2009,3(2):97-137.
[3] Lynch HT,Watson P,Bewtra C,et al.Hereditary ovarian cancer heterogenicity in age at diagnosis.Cancer,1991,67(5):1460-1466.
[4] Rebbeck TR,Mitra N,Domchek SM,et al.Modification of ovarian cancer risk by BRCA1/2 interacting genes in a multicenter cohort of BRCA1/2 mutation carriers.Cancer Res,2009,69(14):5801-5810.
[5] Emmanuel C,Gava N,Kennedy C,et al.Comparison of expression profiles in ova rian epithelium in vivo and ovarian cancer identifies novel candidate genes involved in disease pathogenesis.PLos One,2011,6(3):e17617.
[6] Braem MG,Onland-Moret NC,van den Brandt PA,et al.Reproductive and horm onal factors in association with ovarian cancer in the Netherlands cohort study.Am J Epidemiol,2010,172(10):1181-1189.
[7] 张师前,孙伟,殷立基.生殖因素与卵巢癌发病危险的病例对照研究进展.肿瘤防治研究,1995,22:191-192.
[8] 王素芳,叶冬青,曹云霞.52例恶性上皮性卵巢肿瘤病例对照研究.中国肿瘤,2000,9:327-328.
[9] Ness RB,Dodge RC,Edwards RP,et al.Contraception methods,beyond oral contrac eptives and tubal ligation,and risk of ovariancancer.Ann Epidemiol,2011,21(3):188-196.
[10] Schouten LJ,Rivera C,Hunter DJ,et al.Height,body mass index,and ovarian cancer a pooled analysis of 12 cohort studies.Cancer Epidemiol Biomarkers Prev,2008,17(4):902-912.
[11] Gran WB.An ecological study of cancer mortality rates in the United States with respect to solar ultraviolet-B doses,smoking,alcohol consumption and urban/rural residence.Dermatoendocrinology,2010,2(2):68-76.
[12] Kotsopoulos J,Vitonis AF,Terry KL,et al.Coffee intake,variants in genes involv ed in caffeine metabolism and the risk of epithelial ovarian cancer.Cancer Causes Control,2009,20(3):335-344.
[13] Redman CW,Bleckledge GR,Kelly K,etal.Early serum CA 125response and outco me in epithelial ovarian cancer.Eur Cancer,1990,26:593-596.