Study On Platinum Resistance And Prognosis Influencing Factors In Patients With Ovarian Cancer Based On CT And Clinical Features

Objective:To explore the risk factors of drug resistance and prognosis in patients with ovarian cancer based on CT and clinical characteristics,so as to provide evidence for improving the prognosis of patients.Methods:The clinical data and imaging features of 164patients with epithelial ovarian cancer(EOC)treated in our hospital from January 2016 to January2022 were analyzed retrospectively.According to the different reactions to chemotherapeutic drugs,patients were divided into drug-resistant group and non-drug-resistant group.Non-parametric test orχ~2test was used in the inter-group univariate analysis.The statistically significant variables in the univariate analysis were included in the multivariate Logistic regression analysis.The independent risk factors affecting drug resistance in patients with epithelial ovarian cancer were obtained,and the predictive performance was evaluated by the receiver operating characteristic curve(ROC).According to whether the patients had recurrence or death,the patients were divided into recurrent group and non-recurrent group.Cox proportional regression model was used to analyze the independent risk factors for the prognosis of patients with ovarian cancer.Kalan-Meier survival curve was used to investigate the independent risk factors and Log-rank test was used to compare their differences.Results:1.A total of 31 cases were included in the drug-resistant group and 133cases in the non-drug-resistant group.Univariate analysis showed that there were significant differences in treatment,International Federation of Gynecology and Obstetrics,FIGO stage,carbohydrate antigen 125(CA125),tumor focus composition,peritoneal cancer index(peritoneal Cancer Index assessed on preoperative CT,CT-PCI),ascites,lymph node metastasis and distant organ metastasis between the two groups.Multivariate Logistic regression analysis showed that CA125(OR=1.02,95%CI:1.010-1.210,0.011),distant organ metastasis(OR=5.538,95%CI:1.303-23.538)and CT-PCI(OR=1.157,95%CI:1.053-1.270)were independent risk factors for drug resistance in patients with epithelial ovarian cancer.The area under the curve(AUC)of the three factors to predict drug resistance in patients with epithelial ovarian cancer was 0.845,which showed the strongest predictive ability.2.A total of 74 patients with recurrence and 90 patients without recurrence were included in this study.Univariate analysis of Cox proportional risk regression model showed that Prognosis and treatment of epithelial ovarian cancer(P=0.001),age(P=0.019),FIGO stage(P<0.001),tumor lesion components(P=0.005),abdominal effusion(P=0.008),CT-PCI(P<0.001),lymph node metastasis(P=0.011),CA125(P=0.011)and distant organ metastasis(P=0.001),there was a statistical difference between groups.Multivariate analysis of Cox proportional risk regression model showed that CT-PCI(OR=1.072,95%CI:1.023-1.122,P=0.003)and distant organ metastasis(OR=3.074,95%CI:1.496-6.317,P=0.002)was an independent risk factor for patients with PFS.The results of Kalan-Meier survival curve showed that PFS in patients with CT-PCI≥5 was shorter than that in patients with CT-PCI<5,and PFS in patients with distant organ metastasis was shorter than that in patients without distant organ metastasis.Log-rank analysis showed that the differences were statistically significant(P<0.05).Conclusions:1.CA 125,CT-PCI and distant metastasis have a certain predictive value for drug resistance in ovarian cancer patients,and the combined diagnosis of the three has the highest clinical predictive performance.2.The higher the distant organ metastasis and CT-PCI value,the worse the prognosis of patients with ovarian cancer.