【摘要】 目的：探讨术前CT、血清HE4水平、PLR在晚期卵巢癌初次肿瘤细胞减灭术结局中的预测价值。方法：收集2014年1月—2021年12月行初次减瘤术的晚期上皮性卵巢癌、腹膜癌患者的临床、影像资料，采用ROC曲线分析评估患者术前CT、HE4及PLR对不满意减瘤术的预测价值，使用二元Logistics回归进行多因素分析。结果：不满意减瘤术组的术前CT评分、HE4水平、PLR均显著高于满意减瘤术组（P<0.05）;HE4水平与PLR预测减瘤术结局的最佳截止值分别为311 pmol/L、180,AUC分别为0.737、0.735，灵敏度分别为77.8%、83.3%，特异度分别为66.7%、60.0%。术前CT评分预测手术结局的AUC为0.787,CT评分≥2分时，预测不满意减瘤术结局的灵敏度及特异度分别为68.5%及70.0%。术前CT、HE4及PLR均为不满意减瘤术的独立预测因素，三者联合预测不满意减瘤术结局的AUC为0.847，灵敏度及特异度分别为87.0%、76.7%。结论：术前CT、HE4及PLR分别对晚期上皮性卵巢癌不满意减瘤术结局有一定预测价值，三者联合预测价值优于单因素独立预测。更多还原

【Abstract】 Objective: To investigate the predictive value of preoperative CT scan, serum human epididymis protein 4(HE4) level and platelet to lymphocyte ratio(PLR) in the outcome of primary debulking surgery for advanced ovarian cancer.Methods: This study included 84 patient with advanced epithelial ovarian cancer and peritoneal cancer who underwent primary debulking surgery from January 2014 to December 2021. The clinical and radiological data were collected. The predictive value of preoperative CT, HE4 and PLR in suboptimal debulking surgery was evaluated by receiver operating characteristic curve(ROC) analysis, and binary logistic regression. Results: The preoperative CT score, HE4 level and PLR in the suboptimal debulking surgery group were significantly higher than those in the optimal debulking surgery group(P<0.05). The optimal cutoff values of HE4 level and PLR for predicting the outcome of debulking surgery were 311 pmol/L and 180, the area under the ROC curve were 0.737 and 0.735, respectively. The sensitivity were 77.8% and 83.3%, respectively, and the specificity were 66.7% and 60.0%, respectively. The area under the ROC curve of CT for predicting the outcome of debulking surgery was 0.787. When the CT score was greater than or equal to 2, the sensitivity and specificity of predicting the outcome of suboptimal debulking surgery were 68.5% and 70.0%, respectively. Preoperative CT scan, serum HE4 and PLR were independent predictors of suboptimal debulking surgery. The area under the ROC curve of the combined prediction of suboptimal debulking surgery was 0.847, and the sensitivity and specificity were 87.0% and 76.7%, respectively. Conclusion: Preoperative CT, HE4 and PLR have a certain predictive value for the outcome of suboptimal debulking surgery for advanced epithelial o-varian cancer, and the combined predictive value of the three is better than that of single factor.更多还原