| Objective: to explore the clinical applicability of the dualist model for epithelial ovarian cancer and to provide a basis for more accurate prognosis evaluation.Methods: In this paper,using retrospective analysis method,the 2013-01 to 2014-02 clinic and hospital department of gynaecology parallel surgery plus chemotherapy(3-8),and other comprehensive reatment of 141 cases of primary epithelial ovarian cancer patients,using the latest international ovarian cancer "dualism model" put forward by the classification standard of the collected cases to parting is classified as type I and type II ovarian cancer,ovarian cancer;By comparing the two groups of age,FIGO stage,tumor size,ascites volume,postoperative abdominal whether can achieve ideal tumor(R0 / lesions residue)to cut loss,preoperative CA125 level and chemotherapy after 3 cycles CA125 is down to normal levels,platelet count,fibrinogen,neutrophils/Lymphocyte ratio(Neutrophil-to-Lymphocyte ratio,NLR),to compare the prognosis of the two groups.Results:1.As of March 17,2019,among the 141 cases of ovarian cancer,64 patients died,55 cases survived,22 cases lost follow-up,Type I ovarian cancer accounted for 9%(6/64)and type II ovarian cancer accounted for 91%(58/64).The 5-year progressive-free survival rate was 56% and 19.4%,respectively.Among 97 cases with recurrence,type I ovarian cancer accounted for 10.3%(10/97),type II ovarian cancer accounted for 89.7%(87/97),and the 5-year overall survival rates were 73% and 39.3%,respectively.2.The results showed that the age group of type I epithelial ovarian cancer was 23-68 years old,with an average of 50.35 years old;the range of incidence of type II ovarian cancer was 28-75 years old,with an average age of 54.73 years old.There was a statistical difference between the two groups(t=-2.301.P = 0.023).12 patients with early stage of type I ovarian cancer(FIGO stage I-II),accounting for 46% of the total.13 patients with early stage of type II ovarian cancer(FIGO stage I-II),accounting for 11% of the total.The comparison between the two groups was statistically significant(χ2=12.656,P=0.000).The preoperative tumor diameter of type I ovarian cancer was compared with that of type II,and the formation of large pelvic masses was more common in the type I groups(χ2=12.874,P=0.001).Postoperative type I ovarian cancer patients are more likely to achieve ideal tumor cell reduction(R0)than type II ovarian cancer patients(χ2=8.772,P=0.003).Patients with type II ovarian cancer also had significantly more ascites at onset than those with type I ovarian cancer(χ2=5.932.P=0.015);Among the patients with abnormal preoperative increase of CA125,type II ovarian cancer was significantly more than that of type I ovarian cancer(χ2=4.719,P=0.030);After 3 courses of chemotherapy,patients with type I ovarian cancer were more likely to drop to normal level than those with type II ovarian cancer(χ2=7.773,P=0.005);There were no significant differences in neutrophil/lymphocyte(NLR),platelet count,fibrinogen and other blood routine results between the two groups(P>0.05).Conclusion: Compared with type II ovarian cancer,type I ovarian cancer has a smaller age of onset and a larger tumor,so it is easier to achieve the ideal tumor cell reduction(R0).In addition,the postoperative pathological stage is earlier,and CA125 is easier to reduce to the normal level after 3 courses of chemotherapy.The preoperative ascites of patients with type II ovarian cancer were generally higher than those of type I patients,and the preoperative level of tumor marker CA125 was also significantly higher than that of patients with type I ovarian cancer.The 3-year and 5-year progression-free survival rate and overall survival rate of patients with type II ovarian cancer were worse than those of type I ovarian cancer.It suggests that the two have differences in clinicopathological characteristics.The prognosis of type I ovarian cancer is better than that of type II ovarian cancer.The "dualist model" of epithelial ovarian cancer can more reasonably reflect the different prognosis of the two types of ovarian cancer,which has better clinical application value.In addition,the comparison of hemogram related indicators between the two groups showed no significant statistical significance except that platelet count had an effect on progression-free survival.Contrary to the literature,more data are needed to confirm the recognition of tumor microenvironment between types of ovarian cancer. |
