Clinical Value Of Preoperative LMR Combined With CA125 In The Prognosis Of Advanced Serous Ovarian Cancer

Purpose:The purpose of this study was to retrospectively investigate the correlation between preoperative LMR combined with CA125 and survival in 105 patients with advanced serous ovarian cancer and to discuss the prognostic value of LMR combined with CA125 in advanced serous ovarian cancer.Method:The medical records of ovarian cancer patients who underwent primary cytoreductive surgery in Gansu Provincial Hospital from 2012.6—2019.6 were collected,and the medical records of 105 patients with advanced serous ovarian cancer who met the conditions for this study were retrospectively analyzed,preoperative lymphocyte count,monocyte count and preoperative CA125 were recorded.By establishing the receiver operating characteristic curve(ROC)for predicting patient mortality with preoperative LMR,CA125 and preoperative LMR combined with CA125(COLC),to determine the best cut-off value of LMR and CA125 for predicting patient mortality.The predictive ability of LMR,CA125 and COLC for the mortality of patients were compared by the area under the curve(AUC).According to the best cut-off value of LMR and CA125,the patients were divided into high LMR group and low LMR group,high CA125 group and low CA125 group.The differences of survival rates among different groups were calculated and the independent prognostic factors of patients with advanced serous ovarian cancer were determined.Result: 1.The ROC curve results showed that the best cut-off value of preoperative LMR and CA125 for predicting patient mortality are 3.72 and 638.83U/m L,the correct indices were 0.403 and 0.629,the sensitivity and specificity of LMR were 55.2% and 85.1%,CA125 were 78.7% and 84.2%,and the AUC were 0.745 and0.874 respectively,both of which were prognostic indicators for patients with advanced serous ovarian cancer.2.Postoperative progression free survival(PFS)was analyzed.Univariate analysis showed that ascites(P=0.007),preoperative low LMR(P=0.020),and preoperative high CA125(P < 0.001)were all associated with PFS.Multivariate analysis showed that ascites(HR=1.999,95%CI: 1.280-3.123,P=0.002)and preoperative high CA125(HR=2.267,95%CI: 1.453-3.538,P < 0.001)were independent risk factors for PFS in patients with advanced serous ovarian cancer.3.Postoperative overall survival(OS)was analyzed.Univariate analysis showed that ascites(P = 0.015),preoperative low LMR(P < 0.001),and preoperative high CA125(P < 0.001)were all associated with OS.Multivariate analysis showed that the ascites(HR = 2.070,95% CI: 1.132-3.787,P = 0.018),preoperative low LMR(HR =4.753,95% CI: 1.883 – 11.999,P = 0.001)and preoperative high CA125(HR = 9.031,95% CI: 4.558 – 17.823,P < 0.001)were independent risk factors for OS in patients with advanced serous ovarian cancer.4.The sensitivity of preoperative LMR combined with CA125 in predicting the mortality of patients with advanced serous ovarian cancer was 61.7%,the specificity was 86.2%,and the AUC was 0.878,which was higher than LMR(AUC = 0.745)and CA125(AUC = 0.874).In other words,preoperative LMR combined with CA125 had better prognostic effect and higher specificity for advanced serous ovarian cancer.Conclusion: 1.Preoperative LMR is an independent prognostic factor in patients with advanced serous ovarian cancer.2.For patients with advanced serous ovarian cancer,ascites and preoperative high CA125 are independent risk factors for PFS;ascites,preoperative low LMR and preoperative high CA125 are independent risk factors for OS.3.LMR combined with CA125 can be used to evaluate the prognosis of advanced serous ovarian cancer,and has a high specificity.