Analysis Of Risk Factors Associated With Recurrent Types Of Epithelial Ovarian Cancer

Objective:To explore the correlation between recurrence types of epithelial ovarian cancer (EOC)and clinical factors,and to study the relationship between platinum-free interval(PFI)and genetic predisposing genes in relapsed patients,to provide a basis for the prognosis evaluation and whole-process management of ovarian cancer.Methods:Collected 259 patients with recurrent ovarian cancer who attended the Second Hospital of Jilin University from January 2017 to December 2022.The patients were divided into platinum-sensitive and platinum-resistant relapse groups according to whether PFI(Platinum-free interval,PFI)was longer than 6 month.The age at diagnosis,age at menarche,menstruation,pregnancy,parity,family history,and CA125 at diagnosis(Cancer antigen,CA),CA199 level,CA125,CA199 decline after the first chemotherapy(after initial tumor reduction or the first chemotherapy of NACT),abdominal water volume,maximum diameter of the lesion at diagnosis,lymph node resection,lymph node metastasis,pathological type,FIGO(Federation international Gynecology and Obstetrics,FIGO)stage,neoadjuvant chemotherapy,number of first-line chemotherapy courses,BRCA(Cancer Susceptibility Genes,BRCA)gene mutation,HRD(Homologous recombination deficiency,HRD)state,To explore relevant clinical and genetic factors affecting the recurrent types of epithelial ovarian cancer.Results:1.Univariate Logistic regression analysis showed: CA125 level at diagnosis(P=0.002),CA125 decrease after first chemotherapy(P=0.000),abdominal water volume(P=0.000),neoadjuvant chemotherapy(P=0.000),lymphadenectomy(P=0.009),FIGO stage(P=0.004),were all P<0.05,There was statistical significance,suggesting that the above factors were considered significantly different in the two groups of patients with recurrent ovarian cancer,and were related factors affecting the recurrent type of epithelial ovarian cancer.2.In multivariate Logistic regression analysis,abdominal water volume(P=0.005,OR=2.382,95%CI= 1.300-4.376)and neoadjuvant chemotherapy(P=0.001,OR=3.128,95%CI= 1.548-6.321)was an independent risk factor for recurrent type of epithelial ovarian cancer.3.Among recurrent ovarian cancer patients,77 cases of platinum-resistant recurrence,accounting for 29.73%.4.Among the 21 patients with BRCA gene mutations,most of them were germ line BRCA1 gene mutations(13 cases,56.52%),pathogenic mutations(17 cases,73.91%),frameshift mutations(10 cases,47.62%),and most of the mutant gene subregions were Exon11 gene subregions(4 cases,19.05%).5.Hot spot mutations may be present in 3 patients with recurrent ovarian cancer,of which 2 patients have the same mutation site.6.Among the patients with BRCA gene mutations,one or more relatives had different cancers within three generations,most of which were lung cancer and digestive system malignancies.Among them,one patient had a personal history of breast cancer combined with g BRCA1 and g BRCA2 mutations,and all of the patients had germline BRCA mutations.7.In this study,259 patients with recurrent epithelial ovarian cancer,including 182 in the platinum-sensitive relapse group and 77 in the platinum-resistant relapse group,including 96 patients with genetic tests,37 patients with HRD tests and 21 with BRCA gene mutations.At diagnosis,age at menarche,age at menopause,menopause,pregnancy,birth,cancer,CA199 level at diagnosis,CA199 decline after diagnosis,the maximum diameter of lesions at diagnosis,lymph node metastasis,pathological type,number of first-line chemotherapy courses,BRCA gene mutation status,BRCA gene mutation type,HRD status(P> 0.05),suggesting that there was no difference in the above factors between the two groups of recurrent ovarian cancer patients in this study.Conclusion:1.CA125 level at diagnosis,CA125 decline after the first chemotherapy,abdominal water volume,neoadjuvant chemotherapy,lymph node resection,FIGO stage are related factors affecting the type(platinum-sensitive recurrence,platinum-resistant recurrence)of epithelial ovarian cancer recurrence.2.Epithelial ovarian cancer patients with 1000 ml of abdominal fluid and neoadjuvant chemotherapy are prone to platinum-resistant recurrence.3.No association has been found between genetic susceptibility genes and platinum-free interval in epithelial ovarian cancer.4.Among recurrent epithelial ovarian cancer with BRCA gene mutation,g BRCA1 gene has the highest incidence of pathogenic mutation.5.Platinum-resistant recurrence is about 29.73% in patients with recurrent ovarian cancer.Genetic screening,accurate diagnosis and targeted therapy for high-risk groups are beneficial to obtain a better prognosis for patients with epithelial ovarian cancer.