| Purpose:This study aims to retrospectively analyze the effects of preoperative thrombocytosis on clinical factors and Disease-free Interval of epithelial ovarian cancer,To explore how to improve the prognosis of ovarian cancer by interfering with platelets,and to provide research directions for the discovery of new therapeutic targets for epithelial ovarian cancer.Method:Patients with epithelial ovarian cancer who were treated in the gynecology department of the First Hospital of Jilin University from January 2010 to January2016 were selected an,After exclusion according to inclusion criteria,135 patients met the criteria.According to the preoperative platelet count,135 patients were divided into a thrombocytosis group(PLT≥300×10~9/L)and a platelet normal group(PLT<300×10~9/L).The differences in age,first-time residual lesion diameter,FIG0stage,histological grade,pathological type,serum CA125 and 2 post-chemotherapy serum CA125 and the Disease-free Interval of the two groups were compared.Statistical methods:All data were processed using SPS 17.0 software,measurement data were expressed as(±S),and t-test was used for comparison between groups.The relationship between platelet count and clinical characteristics was analyzed by X~2 test,the logistic regression analysis was used for Multivariate analysis.If P<0.05,the difference is considered to be statistically significant.Result:1.135 patients with ovarian cancer,68 patients with normal platelets,67 patients with thrombocytosis.2.The results of single factor analysis of thrombocytosis group and platelet normal group showed:(1)Age:Patients with age≥50 years,preoperative average platelet count:(328.59±12.9)×10~9/L;<50 years old patients with preoperative average platelet count:(320.91±14.9)×10~9/L,age and There was no significant difference in preoperative platelet counts(P=0.69).(2)The size of the postoperative residual lesions:In patients with normal platelets,52 patients(76%)had residual lesions less than 1 cm,In patients with thrombocytosis,41 patients(61%)had residual lesions less than 1 cm for the first time.the difference was statistically(P=0.03).(3)FIGO stage:Among the patients with thrombocytosis,there are 13 patients with early(I/II)ovarian cancer,accounting for 19%,and 29 patients with normal ovarian cancer,accounting for 43%,the difference was statistically(P=0.002).(4)Histological grade:Among the patients with thrombocytosis,9 patients were low-grade ovarian cancer,accounting for 13%,and those with normal platelets,22patients with low-grade ovarian cancer,accounting for 32%,the difference was statistically(P=0.007).(5)Pathological type:There was no significant difference between the preoperative platelet count and the pathological types of ovarian cancer patients(P=0.639).(6)Preoperative serum CA125 levels:There was no significant difference in preoperative serum CA125 levels between patients with thrombocytosis and those with normal platelets(P=0.064).(7)Changes in CA125 after 2 courses of chemotherapy:After 2 courses of chemotherapy in the thrombocytosis group,38 patients had CA125 decreased to normal,accounting for 56%.In the normal platelet group,54 patients had normal CA125 after 2 courses of chemotherapy,accounting for 79%,the difference was statistically significant(P=0.002).(8)Disease-free Interval:median Disease-free Interval was 7 months in patients with thrombocytosis;median Disease-free Interval was 20 months in normal platelet patients,the difference was statistically significant(P=0.007).(9)Types of ovarian cancer recurrence:The number of drug-resistant recurrences in the thrombocytosis group was 36,accounting for 53%,and the number of drug-resistant recurrences in the normal platelet group was 19,accounting for 28%,the difference was statistically significant(P=0.003).3.Univariate analysis showed that the residual diameter,clinical stage,histological grade,CA125 change after 2 courses of chemotherapy,and preoperative platelet count were the risk factors for the Disease-free Interval of patients with ovarian cancer.4.Multivariate analysis showed that the residual diameter,clinical stage and preoperative platelet count were the independent risk factors for the Disease-free Interval of patients with ovarian cancer.Conclusion:Patients with thrombocytosis tend to be later in FIGO stage,and the tissue differentiation is worse,Achieving ideal tumor cytoreductive surgery(defined as residual disease less than 1 cm)is less likely,and the disease-free interval is shorter.Therefore,it is necessary to pay attention to preoperative platelet count,which may be related to tumor cell invasion,progression and poor prognosis. |
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