CA125表达正常的上皮性卵巢癌患者的临床病理及血细胞变化特征OA

Objective:To investigate the clinicopathological and hematological charac-teristics of patients with epithelial ovarian cancer(EOC)and normal serum CA125 level(<35U/mL),identify risk factors for tumor recurrence and survival patterns,and provide evidence for individualized postoperative follow-up strategies.Methods:A retrospective cohort study was conducted.A total of 269 EOC patients diagnosed and treated with standard therapy in our hos-pital from January 2011 to December 2021 were enrolled.Patients were divided into three groups according to baseline serum CA125 level:normal expression group(CA125<35U/mL,n= 66),mild elevation group(CA125 35～100U/mL,n = 48)and high expression group(CA125>100U/mL,n= 155).Clinicopathological parameters including tumor stage and patho-logical type,as well as hematological indicators such as platelet count and hematocrit were com-pared among groups.Univariate and multivariate binary logistic regression analyses were used to screen independent risk factors for recurrence.Cox proportional hazards regression model was applied to analyze prognostic factors affecting recurrence.Kaplan-Meier method was used to plot survival curves,and Log-rank test was adopted to compare survival differences between groups.Results:Significant differences were observed in the distribution of tumor stage and pathological type among the three groups(all P<0.001).Statistically significant intergroup differences were also found in white blood cell count,platelet count and hematocrit(P= 0.006,P<0.001,P=0.004,respectively).Recurrence rate presented a graded upward trend with the increase of baseline CA125 level.In patients with normal CA125 level,hematocrit and platelet count were significantly correlated with recurrence.Elevated hematocrit increased recurrence risk(OR =1.3,95％CI:1.1～1.7,P= 0.016).Multivariate binary logistic regression revealed obvious heterogeneity of platelet count effect on recurrence risk between normal and high CA125 groups.Higher platelet count was associated with lower recurrence risk in patients with normal CA125.Increased recurrence risk related to elevated platelet count was only observed in the un-adjusted model of high CA125 group.Kaplan-Meier survival analysis indicated that recurrence-free survival rate decreased remarkably along with rising CA125 level(P<0.0001),and tumor recurrence mainly occurred in the early postoperative period in high CA125 group.Conclusion:EOC patients with normal CA125 level represent a special subtype with distinct clinicopatholog-ical and hematological features.Hematocrit and platelet count exert discrepant effects on recur-rence risk.The correlation between platelet count and recurrence risk differs from that in pa-tients with elevated CA125.In clinical practice,attention should be paid to PLT and HCT in pa-tients with normal CA125 expression to enhance the early detection of tumor recurrence.