Changes of coagulation function before and after neoadjuvant chemotherapy in patients with ovarian cancer and their clinical significance
Objective To investigate the changes of coagulation,fibrinolysis and platelet indexes in ovarian cancer patients before and after neoadjuvant chemotherapy,and to analyze the risk relationship between relevant indexes before treatment and the effect of neoadjuvant chemotherapy(NACT).Methods Patients with ovarian cancer admitted to Xi'an Fengcheng Hospital,from March 2020 to March 2023 were included as the ovarian cancer group,and female patients who underwent physical examination in the same period were selected as the control group according to a 2∶1 ratio.Prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),platelet distribution width(PDW),platelet hematocrit(PCT),platelet(PLT)and mean platelet volume(MPV)were compared between the two groups.The changes of these indexes were compared before and after NACT,at different clinical stages and before and after NACT with different efficacy effects.Moreover,they were divided into effective and ineffective groups according to their treatment efficacy.Logistic regression was used to explore the relationship between the parameters and NACT efficacy;receiver operating characteristic curve was drawn to predict the value of NACT efficacy.Results A total of 144 patients were included,with 96 cases in the ovarian cancer group and 48 in the control group.The FIB,PLT and MPV of patients in the ovarian cancer group were higher than those in the control group(P<0.05).The PT,TT,APTT,FIB and PLT of ovarian cancer patients after NACT were lower than those before NACT(P<0.05).FIB and PLT of stage Ⅱ patients were lower than those of stage Ⅲ before and after NACT,and the PT,TT,APTT,FIB and PLT of the effective group were lower than those of the ineffective group before and after NACT,and the PT,TT,APTT,FIB and PLT of the two groups after NACT were lower than those before NACT(P<0.05).Multivariate Logistic regression analysis indicated that high PT,TT,APTT,FIB and PLT before NACT were independent risk factors for NACT ineffectiveness(P<0.05).The area under the curve of PT,TT,APTT,FIB and PLT before NACT to predict the effect of NACT were 0.713(sensitivity of 80.95%,specificity of 69.33%),0.756(sensitivity of 71.43%,specificity of 82.67%)and 0.787(sensitivity of 76.19%,specificity of 70.67%),0.727(sensitivity of 71.43%,specificity of 84.00%),0.794(sensitivity of 80.95%,specificity of 76.00%),respectively.Conclusion Changes in coagulation and fibrinolytic function and platelet parameters in ovarian cancer patients after NACT are associated with clinical stages and NACT effect.High levels of PT,TT,APTT,FIB and PLT before NACT are important reasons affecting NACT effect.Constructing the risk prediction model of NACT efficacy in ovarian cancer patients based on the above five parameters can provide a reference for clinical practice.
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维普
