Ovarian Malignant Abdominal Cavity Lymph Node Metastases And The Biological Significance Discussed

Objective:To explore the clinical value of retroperitoneal lymphadenectomy for ovarian cancer.Methods:A retrospective review was performed among 361 patients treated between 1985 and 2002 at the Department of Gynecologic Oncology of Guangxi Cancer Hospital. Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test.Independent prognostic factors were identified by the COX proportional hazards regression model.Results:The survival rate could not be improved through retroperitoneal lymphadenectomy in the patients with early stage(P＞0.05).The survival rate could be improved through retroperitoneal lymphadenectomy in the patients with advanced stage(P＜0.05).5-year survival was longer in patients whose size of residual tumor＜2 cm than＞or =2cm. Multivariate analysis showed that stage,residual tumor,retroperitoneal lymphadenectomy and the number of courses of chemotherapy is the prognostic factors in patients with epithelial ovarian cancer.Conclusion:Lymphadenectomy is associated with improved survival in patients with early clinical stage ovarian cancer and residual tumor＜2 cm.Objective:To explore the clinical Diagnosis value of retroperitoneal lymph micrometastases of CK18 and CA125 in the ovarian cancer.Methods:CK18 and CA125 were detected by immunohistochemistry(IH)in retroperitoneal lymph nodes and primary site in 60 cases among 361 patients,clinical evaluates of CK18 and CA125 included sensitivity,specificity, accuracy,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio,Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test.Results:Expressions of CK18 and CA125 in retroperitoneal lymph nodes were more significantly higher than in primary site.The positive rate of 1H was more significant than H-E detection in the retroperitoneal lymph nodes.Positive espression of CK18 and CA125 were relevant factor with clinical phase of the ovarian cancer in the retroperitoneal lymph nodes,but it there were no relations with the prognosis.Conclusion: Detection of CK18 and CA125 can play inportant roles in diagnosis for micrometastases in the retroperitoneal lymph nodes.Objective:To detect the expression of metastasis genes and observe the characters of molecular biology in retroperitoneal lymph nodes.Methods:Ki-67,P53,PTEN,PTTG were detected by IH in retroperitoneal lymph nodes and primary site.Survival was calculated by Kaplan-Meier method and comparison was performed using Log-rank test.Independent prognostic factors were identified by the COX proportional hazards regression model.Results: Positive expression of Ki-67 in primary site was more higher lever than in retroperitoneal lymph nodes.Positive espression of Ki67 was relevant factor with clinical phase of the ovarian cancer in the retroperitoneal lymph nodes.Chemical therapy has relation with espression of Ki-67P53,PTEN,PTTG and the prognosis.In Kaplan-Meier survival analysis,espression of Ki-67,P53, PTEN and PTTG in retroperitoneal lymph nodes has no relation with the prognosis.In the COX analysis,colic- metabasis as independent prognostic factors can influence the prognosis. Conclusions:P53,PTEN,PTTG and Ki-67 play the inportant roles in metastasis of the retroperitoneal lymph nodes.Especially,there is a inportant clinical value of high level expression of Ki-67.