Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2022, Vol. 18 ›› Issue (02): 150 -157. doi: 10.3877/cma.j.issn.1673-5250.2022.02.005

Original Article

Influencing factors of venous thromboembolism in women with ovarian clear cell carcinoma

Jie Deng1,2, Yiran Wang1, Ping Wang1,()   

  1. 1Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
  • Received:2021-11-19 Revised:2022-03-01 Published:2022-04-01
  • Corresponding author: Ping Wang
  • Supported by:
    Key Research and Development Project of Science and Technology Department of Sichuan Province(2021YFS0015)
Objective

To explore influencing factors of venous thromboembolism (VTE) in patients with ovarian clear cell carcinoma (OCCC).

Methods

From February 2012 to February 2021, 221 women with OCCC who underwent gynecological surgery and confirmed by pathology in the West China Second University Hospital, Sichuan University were enrolled. According to whether the occurrence of VTE or not, they were divided into VTE group (n=39) and non-VTE group (n=182) by retrospective analysis mothod. The clinical data, intraoperative situation and VTE characteristics in two groups were retrospectively analyzed. The uncorrected Kaplan-Meier curve model and log-rank test were used to statistically analyze the median overall survival (OS) time and median progression-free survival (PFS) time between two groups. Multivariate unconditional logistic regression analysis was used to analyze the effect factors of OCCC patients complicated with VTE. There were no significant differences between two groups in age and body mass index (BMI), etc. (P>0.05). The procedure followed in this study was in accordance with the World Medical Association Declaration of Helsinki revised in 2013.

Results

①Among 221 OCCC patients, the incidence of VTE was 17.6%(39/221). There were statistically significant differences in preoperative carbohydrate antigen (CA)125 level and proportion of different International Federation of Gynecology and Obstetrics (FIGO) stages (P<0.05). ②In VTE group, the proportion of open surgery, G-Caprini score, positive rate of lymph nodes, positive rate of cytological examination of ascites or peritoneal lavage fluid, the number of lymph node dissection ≥20, proportion of chemotherapy >6 times, and platinum drug resistance rate were all higher than those in non-VTE group, and the differences between two groups were statistically significant (P<0.05). ③Twenty-six patients (66.7%) had no self-conscious symptoms when they were diagnosed with VTE. VTE occurred in 7 cases (17.9%) before operation, 18 cases (46.1%) after operation, 9 cases (23.1%) during chemotherapy, and 5 cases (12.8%) during OCCC recurrence. VTE occurred in lower limbs, upper limbs, upper limbs+ lower limbs and lungs in 24 cases (61.5%), 6 cases (15.4%), 4 cases (10.3%) and 5 cases (12.8%), respectively. ④Survival analysis showed that the OS time and PFS time in non-VTE group were significantly longer than those in VTE group, and the differences were statistically significant (P<0.05). ⑤The results of multivariate unconditional logistic regression analysis showed that advanced-stage (FIGO staging Ⅲ-Ⅳ) (OR=1.012, 95%CI: 0.110-1.900, P=0.026), and preoperative CA125 level ≥200 U/mL (OR=1.472, 95%CI: 0.476-2.433, P=0.036) were independent influencing factors of OCCC patients complicated with VTE.

Conclusions

VTE is one of the important factors affecting prognosis of patients with OCCC. The prevention and early diagnosis of VTE should be strengthened in FIGO staging Ⅲ-Ⅳ and preoperative CA125 level ≥200 U/mL.

表1 2组OCCC患者临床资料比较
表2 2组OCCC患者手术情况比较
表3 39例OCCC并发VTE患者的VTE类型及发生部位比较[例数(%)]
表4 2组OCCC患者生存结局比较
图2 VTE组与无VTE组患者的PFS曲线
表5 OCCC患者发生VTE影响因素的多因素非条件logistic回归分析结果
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