【摘要】：背景： 卵巢上皮惡性腫瘤是卵巢惡性腫瘤中最常見的腫瘤，可發(fā)生于任何年齡段，發(fā)病率及死亡率高，診斷的特異性差，目前診治面臨諸多難點。目前關(guān)于卵巢上皮惡性腫瘤常用的預(yù)測指標(biāo)有CA125及HE4等。CA125和HE4是目前應(yīng)用比較廣泛的預(yù)測指標(biāo)，能在一定程度上對病情進行預(yù)測，但該指標(biāo)仍然存在著干擾因素多，普遍適用性差，，價格昂貴等負(fù)面因素，因此在臨床應(yīng)用中其預(yù)測效果仍然有一定的局限性。 目前很多學(xué)者已經(jīng)深入的研究了術(shù)前血小板計數(shù)水平對卵巢上皮惡性腫瘤的預(yù)測價值，證實術(shù)前血小板計數(shù)水平在卵巢上皮惡性腫瘤的分期分級、腹水、滿意減瘤術(shù)、化療效果、無瘤生存期及總生存期上均有一定的預(yù)測價值。 卵巢癌的國際婦產(chǎn)科聯(lián)盟（FIGO）分期是手術(shù)病理分期，其準(zhǔn)確性對于卵巢癌的治療十分重要，如果能在術(shù)前對卵巢癌FIGO分期進行預(yù)測，不僅有助于手術(shù)病理分期準(zhǔn)確性的提高，還可以指導(dǎo)治療方案的選擇，如預(yù)測分期高的患者可以直接行新輔助化療等。 本文通過對相關(guān)主題的文獻(xiàn)的篩選，運用統(tǒng)計學(xué)的方法，合并相類似的研究結(jié)果，來探討術(shù)前血小板計數(shù)水平對卵巢上皮惡性腫瘤早期（StageI/II）及晚期（Stage III/IV）的確切預(yù)測價值。 目的：利用可以獲得的數(shù)據(jù)來探討術(shù)前血小板計數(shù)升高對卵巢上皮惡性腫瘤早期（StageI/II）及晚期（Stage III/IV）的預(yù)測價值。 方法：計算機檢索PubMed數(shù)據(jù)庫、Med-Line數(shù)據(jù)庫、萬方數(shù)據(jù)庫、中國學(xué)術(shù)文獻(xiàn)總庫（CNKI），中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM），語言類型為英文或中文，檢索時間為1993年至2013年。兩位研究者獨立對納入文獻(xiàn)進行質(zhì)量評價。內(nèi)容要求是關(guān)于術(shù)前血小板計數(shù)升高和卵巢上皮惡性腫瘤的相關(guān)研究、所有患者都進行了減瘤術(shù)和（或）術(shù)后化療、有明確的病理診斷結(jié)果及腫瘤分期、以血小板計數(shù)升高作為分組依據(jù)的病例對照研究類型文獻(xiàn)。 結(jié)果：總共納入5篇文獻(xiàn)811例患者，提取數(shù)據(jù)后，stata12.0軟件進行meta分析，分析結(jié)果顯示：1.術(shù)前血小板計數(shù)升高對卵巢上皮惡性腫瘤早期（StageI/II）的預(yù)測價值，合并后的RR值為0.53[0.42,0.67]，森林圖中的棱形不與垂直線相交，棱形偏左（I2=0.0%，P=0.538），提示術(shù)前血小板計數(shù)升高組患者診斷為卵巢上皮惡性腫瘤早期（StageI/II）的風(fēng)險��；2.術(shù)前血小板計數(shù)升高組對卵巢上皮惡性腫瘤晚期（Stage III/IV）的預(yù)測價值，合并后的RR值為1.37[1.24,1.51]，森林圖中的棱形不與垂直線相交，棱形偏右（I2=0.0%，P=0.590），提示術(shù)前血小板計數(shù)升高組患者診斷為卵巢上皮惡性腫瘤晚期（Stage III/IV）的風(fēng)險大；3.“PLT400×109/L”做為定義術(shù)前血小板計數(shù)升高標(biāo)準(zhǔn)的指標(biāo)，可以用來預(yù)測卵巢上皮惡性腫瘤的早期（StageI/II）及晚期（Stage III/IV）。 結(jié)論： 1.術(shù)前血小板計數(shù)升高作為卵巢上皮惡性腫瘤在體內(nèi)的病情進展情況的一個重要標(biāo)志，可以預(yù)測卵巢上皮惡性腫瘤的分期； 2.“PLT400×109/L”做為定義術(shù)前血小板計數(shù)升高的標(biāo)準(zhǔn)在預(yù)測卵巢上皮惡性腫瘤分期上有一定的臨床應(yīng)用價值。
[Abstract]:Background: Ovarian epithelial tumor is the most common tumor in the ovarian malignant tumor. It can be found in any age group. The morbidity and mortality are high. The specificity of diagnosis is poor. Point. Current predictive indicators for ovarian epithelial malignancies are CA125 and HE4 CA125 and HE4 are widely used to predict the condition of the disease. However, there are many negative factors, such as many interference factors, poor general applicability and high price. Therefore, the prediction effect of CA125 and HE4 is still limited in clinical application. At present, many scholars have studied the prediction value of pre-operative platelet count on the malignant tumor of the ovary, and confirm that the level of the pre-operative platelet count is in the stage of stage, ascites and satisfactory detumorization of the malignant tumor of the ovary. has a certain pre-treatment effect on the effect of the fruit, the tumor-free survival time and the overall survival time The staging of the International Obstetrics and Gynecology Union (FIIGO) of ovarian cancer is the pathological stage of the operation, and its accuracy is very important for the treatment of ovarian cancer. If the staging of the FIGO of the ovarian cancer can be predicted before the operation, it is not only helpful for the pathological staging of the operation. the improvement of the accuracy can also guide the selection of the treatment scheme, In this paper, the early stage of ovarian epithelial malignant tumor (StageI/ II) and advanced stage (Stage III/ IV) were discussed by the screening of the literature of the related subjects, the statistical methods and the similar results. Purpose: To explore the early stage of ovarian epithelial malignancies (StageI/ II) and advanced stage (Stage III) using data that can be obtained Methods: The computer searches the PubMed database, the Med-Line database, the Wanfang database, the Chinese Academic Library (CNKI), the Chinese Biomedical Literature Database (CBM), the language type is English or Chinese, and the retrieval time is 1993-2013. The two investigators were independent Quality evaluation was conducted on the inclusion of the literature. The content requirements are related to the increase of pre-operative platelet count and ovarian epithelial malignancies, all of which have been treated with a reduction of tumor and/ or post-operative chemotherapy, with a clear The results of the pathological diagnosis and the staging of the tumor are based on the increase of the platelet count as the grouping basis. Case-control study type literature. Results: A total of 5 literatures were included in 811 patients. After the data was extracted, the stata12.0 software was used for me. The results of the analysis showed that: 1. The pre-operative platelet count increased the predictive value of the early stage of the malignant ovarian tumor (StageI/ II), the combined RR value was 0.53[0.42, 0.67], and the prism in the forest plot did not intersect the vertical line, and the prismatic deviation was left (I2 = 0. 0%, P = 0. 538), suggesting that the pre-operative platelet count increased group was diagnosed as an early stage of ovarian epithelial malignancy (Sta The risk of geI/ II was small; 2. The pre-operative platelet count increased the predictive value of advanced stage (Stage III/ IV) of the ovarian epithelial malignancy, and the combined RR value was 1.37[1.24, 1.51], and the prism in the forest plot does not intersect the vertical line, and the prism is right (I2 = 0. 0%, P = 0. 590), suggesting that the pre-operative platelet count increased group was diagnosed with a high risk of advanced stage of ovarian epithelial malignancy (Stage III/ IV); and 3. The 鈥淧LT400脳109/L鈥

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