1.Application Value of 18F-FDG PET/CT in Ovarian Cancer
Xi LIU ; Yubo LU ; Yingjie ZHU ; Xielan YANG ; Zhiling YAN
Journal of Kunming Medical University 2014;(1):102-105
Objective To evaluate the value of PET/CT in preoperative assessment and postoperative monitoring of ovarian cancer. Methods A retrospective analysis was conducted in 45 patients of ovarian neoplasm with clinical records underwent 18F-FDG PET/CT, including 10 patients underwent PET/CT before surgery and 35 patients after surgery. The clinical follow-up time was 6 months at least. The diagnosis based on pathology and clinical follow-up data. Results (1) The sensitivity, specificity and accuracy of PET/CT in detecting ovarian cancer were 94.6%,75.0%and 91.1%, respectively. (2) Ten patients before surgery were all detected tumor by PET/CT, but 2 of them were false positive based on pathologic results. (3) Two patients with non-standard surgery were detected tumor by PET/CT. In 33 patients after standard surgery, 6 patients were no tumor detected by PET/CT. In addition,4 patients with normal CA125 and no signs of recurrence and metastasis were detected tumor by PET/CT. The pathology and clinical follow-up data supported the results. 23 patients with higher CA125 were diagnosed recurrence and metastasis based on pathology and clinical follow-up data, 21 of them were detected tumor by PET/CT. Conclusion 18F-FDG PET/CT plays an important role in preoperative assessment, early diagnosis and accurate positioning of recurrent and metastasis of ovarian cancer. It can be used to guide the clinical treatment.
2.Effects of paclitaxel combined with carboplatin on expression of VEGF and tumor markers in ovarian cancer
Shufen TAN ; Xielan YANG ; Linlin YANG ; Shuqing LI
Basic & Clinical Medicine 2023;43(12):1861-1865
Objective To explore the effect of paclitaxel with carboplatin combined chemotherapy on hemocyte re-lated indexes,vascular endothelial growth factor(VEGF)and tumor markers in ovarian cancer(OC)patients.Methods OC patients combined chemotherapy(CC)group and ovarian benign tumor control group with 50 cases in each.The pathological changes in the ovarian cells were observed by HE staining and the expression of VEGF was observed by immunohistochemical staining(IHC).Blood cell was counted by flow cytometry(FC).Serum car-bohydrate antigen 125(CA125)and human epididymal protein 4(HE4)were measured by electrochemical lumi-nescence(ECL).Results Compared with control group,the ovarian tissue structure was disordered and the cell atypia was obvious in OC.VEGF expression was significantly enhanced.Platelet count(PLT),CA125 and HE4 were significantly increased(P<0.01).However,necrotic cells were observed in ovarian tissue of CC group.VEGF expression was inhibited.PLT count and the level of CA125 and HE4 were significantly lower than those of control group after chemotherapy(P<0.01).Conclusions Combined chemotherapy may regulate the level of VEGF,CA125 and HE4 in OC patients.
3.Application of TBL and workshop integrated teaching method in clinical training of gynecological oncology
Shufen TAN ; Lipin HE ; Linlin YANG ; Xielan YANG ; Hongying YANG ; Mingjiao YAO ; Shuqing LI
Basic & Clinical Medicine 2024;44(7):1054-1057
Objective To develop a teaching strategy which is suitable for training talents and improving teaching quality in field of clinical gynecological oncology.Methods Seventy-eight clinical students of grade 2020 in a medi-cal university were divided into control group(n=38)and research group(n=40).The"3+2"teaching mode of team-based learning(TBL)and workshop(WS)were adopted,and the learning outcome was evaluated at preview preparation,knowledge application and the questionnaire survey of students,so as to promote the cultivation of clinical reasoning of medical students.Results Compared with traditional teaching method,TBL+WS teaching group had better academic performance.The difference of before class tests and final exams was more significant[17.53±6.15 points and(76.81±5.10)points,respectively,P<0.001].However,among the eight dimensions of the classroom teaching questionnaire,the teaching quality dimension was the highest(97.5%).More students think that this model had a positive effect on cultivating clinical thinking and developing new knowledge.Conclu-sions This integrated teaching strategy improves the quality of obstetrics and gynecology teaching and suppots students'capacity building on clinical reasoning.
4.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
5.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
6.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
7.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
8.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
9.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
10.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.