Constructing an ovarian cancer metastasis index by dissecting medical records
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Yanjun Qu1, Yanan He1, Zhangming Li2, Xiuwei Chen3, Qian Liu4, Shuangshuang Zou1, Congcong Kong1, Yixiu Liu1, Ce Gao4, Guangmei Zhang1 and Wenliang Zhu5
1Department of Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
2Department of Pharmacy, Guangdong Hospital of Integrated Chinese and Western Medicine, Foshan, China
3Department of Gynecology, The Third Affiliated Hospital of Harbin Medical University, Harbin, China
4Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
5Department of Pharmacy, The Second Affiliated Hospital of Harbin Medical University, Institute of Clinical Pharmacy, The Heilongjiang Key Laboratory of Drug Research, Harbin Medical University, Harbin, China
Guangmei Zhang, email: firstname.lastname@example.org
Keywords: ovarian cancer; metastasis; CA-125; model integration; ovarian cancer metastasis index
Received: August 18, 2017 Accepted: September 22, 2017 Published: November 06, 2017
Globally, ovarian cancer (OC) is the leading cause of gynecological cancer-associated deaths. Metastasis, especially multi-organ metastasis, determines the speed of disease progression. A multicenter retrospective study was performed to identify the factors that drive metastasis, from medical records of 534 patients with OC. The average number of target organs per patient was 3.66, indicating multi-organ metastasis. The most common sites of metastasis were large intestine and greater omentum, which were prone to co-metastasis. Results indicated that ascites and laterality, rather than age and menopausal status, were the potential drivers for multi-organ metastasis. Cancer antigen (CA) 125 (CA-125) and nine other blood indicators were found to show a significant, but weak correlation with multi-organ metastasis. A neural network cascade-multiple linear regression hybrid model was built to create an ovarian cancer metastasis index (OCMI) by integration of six multi-organ metastasis drivers including CA-125, blood platelet count, lymphocytes percentage, prealbumin, ascites, and laterality. In an independent set of 267 OC medical records, OCMI showed a moderate correlation with multi-organ metastasis (Spearman ρ = 0.67), the value being 0.72 in premenopausal patients, and good performance in identifying multi-organ metastasis (area under the receiver operating characteristic curve = 0.832), implying a potential prognostic marker for OC.
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