Analysis Of Clinical Factors Related To Recurrence Of Platinum Resistance In Ovarian Cancer

Research background:The incidence and mortality of ovarian cancer are the eighth most common female malignancies.The incidence of ovarian cancer ranks the third and the motality is the second among gynecological malignancies.One of the main causes of failure to achieve clinical remission and even death in patients with ovarian epithelial carcinoma is the development of platinum drug resistance.Even patients who begin to be sensitive to platinum-based drugs will eventually develop resistance to platinum-based drugs after multiple relapses.Ovarian cancer is a heterogeneous disease.Platinum resistance is caused by multiple genes,multiple factors and multiple levels.The purpose of this study is to find the clinical factors causing platinum resistance in ovarian cancer.Purpose of research:Clinical factors associated with platinum drug resistance in ovarian epithelial carcinoma were identified by retrospective analysis.To explore ways to prevent platinum-resistant recurrent ovarian cancer;The patients with high possibility of recurrence of platinum resistance were screened out and the follow-up observation of these patients was strengthened.Research method:From January 2013 to January 2018,a total of 170 patients who met the enrollment criteria and underwent standardized initial treatment in shanxi cancer hospital during the whole process were collected,which were divided into platinum-resistant recurrent ovarian cancer group and platinum-sensitive recurrent ovarian cancer group.Differences in FIGO stage,histological type,pathological grade,neoadjuvant chemotherapy,CA125,HE4 level at initial diagnosis,tumor load,surgical thoroughness,ER,PR and P53 were compared between the two groups to find out the factors affecting platinum resistance recurrence of ovarian cancer.Observation indexes:FIGO staging?histology,pathologic stage,whether neoadjuvant chemotherapy,HE4 and CA125 level was evaluated at the time of initial diagnosis,surgery thoroughness residual lesions(diameter),tumor load(reference Fagotti ploration rating criteria,pie greater omentum 2 points,peritoneal tumor 2 points,diaphragmatic surface tumor,2 points,mesenteric spasm 2 points,tumor invasion and intestinal 2 points,2 points,tumor invasion and stomach liver metastases 2 points),postoperative disease immunohistochemical results.Statistical methods:SPSS 25.0 statistical software was used,and x ~2 test or Fisher exact probability method was used for counting data.The measurement data presented a non-normal distribution,which was represented by"median and quartile(P25,P75)".Multivariate analysis was performed using binary Logistic regression.Research results:1.A total of 170 patients were included in the study,including 30(17.6%)patients in the platinum-resistant recurrent ovarian cancer group and 140(82.4%)patients in the platinum-sensitive recurrent ovarian cancer group.2.Single-factor analysis results of x ~2 tests showed that the proportion of unsatisfactory tumor cell reduction in the platinum-resistant recurrent ovarian cancer group(76.7%)was higher than that in the platinum-sensitive recurrent ovarian cancer group(40.7%),and the difference was statistically significant.3.Platinum resistance of recurrent ovarian cancer with platinum sensitivity of recurrent ovarian cancer groups in the FIGO stage(early-phase I and phase II,late-phase III,IV),histology(serous,not serous),pathologic stage(high level and low level)and ER(+,-),PR(+,-),P53(+,-),neoadjuvant chemotherapy(done,undone)in the exposed ratio difference had no statistical significance.4.The rank sum test results of the comparison of the two samples show that:The HE4 level and the overall median surgical probe score at the initial diagnosis were different between the platinum-resistant recurrent ovarian cancer group and the platinum-sensitive recurrent ovarian cancer group.In other words,there were differences in HE4 level and tumor load at the initial diagnosis between the two groups.There was no significant difference in the level of CA125 between the platinum-resistant recurrent ovarian cancer group and the platinum-sensitive recurrent ovarian cancer group at the initial diagnosis.4.Logistic regression analysis results showed that surgical thoroughness[P=0.005,OR=3.897(95%CI:1.515~9.937)]and the tumor load[P=0.024,OR=1.296(95%CI:1.035~1.624)were statistically significant.The HE4 level at the initial diagnosis(P=0.024)was not statistically significant.Conclusion:1.HE4 level at initial diagnosis may be a factor affecting platinum resistance recurrence of ovarian cancer.2.Surgical thoroughness andt umor load were independent risk factors for recurrence of platinum-resistant ovarian cancer.3.Satisfactory tumor cell reduction is necessary to prevent recurrence of platinum-resistant ovarian cancer.4.In this study,there were no statistically significant differences in FIGO stage,histological type,pathological grade,neoadjuvant chemotherapy,ER,PR,and P53exposure rates between the platinum-resistant recurrent ovarian cancer group and the platinum-sensitive recurrent ovarian cancer group.There was no statistically significant difference in the level of CA125 between the platinum-resistant recurrent ovarian cancer group and the platinum-sensitive recurrent ovarian cancer group at the initial diagnosis.So it was necessary to expand the sample size for further study.