| 徐佳楠,张星光,马建婷,等.PTEN、P53及错配修复蛋白表达与子宫内膜癌病理特征的关系及与预后的相关性[J].肿瘤学杂志,2024,30(6):504-509. |
| PTEN、P53及错配修复蛋白表达与子宫内膜癌病理特征的关系及与预后的相关性 |
| Relationship of PTEN， P53 and Mismatch Repair Protein Expression with Pathological Features and Prognosis in Patients with Endometrial Cancer |
| 投稿时间：2024-03-26 |
| DOI：10.11735/j.issn.1671-170X.2024.06.B009 |
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| 中文关键词: 子宫内膜肿瘤 PTEN P53 错配修复 无病生存期 |
| 英文关键词:endometrial neoplasms PTEN P53 mismatch repair disease-free survival |
| 基金项目:宁波市自然科学基金项目（2021J027） |
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| 摘要点击次数: 119 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨PTEN、P53、DNA错配修复（mismatch repair，MMR）蛋白表达与子宫内膜癌病理特征的关系及与预后的相关性。［方法］ 回顾性分析2018年1月至2022年6月在余姚市人民医院初次行全面分期手术治疗的118例子宫内膜癌患者的临床资料，根据免疫组化结果，将患者分为PTEN突变组、P53 突变组、错配修复缺陷（deficient mismatch repair，dMMR）组，比较各组患者的病理特征及预后差异。采用 Kaplan-Meier 法绘制无病生存（disease-free survival，DFS）曲线。临床一般资料及高危病理因素对子宫内膜癌患者DFS的影响采用单因素Log-rank法分析，将单因素分析中P<0.05的因素纳入Cox比例风险回归多因素分析。［结果］ 118例患者中，PTEN突变85例（72.03%），P53突变30例（25.42%），dMMR 30例（25.42%），3组间肌层浸润、脉管浸润、淋巴结转移、特殊病理类型等病理因素差异均有统计学意义（P均<0.05）。PTEN突变组与未突变组DFS分别为 72.02 个月、48.85个月（P<0.001），P53未突变组与突变组DFS分别为71.54个月、43.21个月（P<0.001），dMMR组与非dMMR组DFS差异无统计学意义（P=0.450)。PTEN突变、P53突变及dMMR 3组间DFS差异有统计意义（P<0.001)。单因素分析显示，术前CA125值及临床高危病理因素（高级别G3、肌层浸润>1/2、肿瘤直径>2 cm、脉管浸润、淋巴结转移、特殊病理类型）对子宫内膜癌患者的DFS 均有影响（P<0.05）。多因素Cox比例风险模型显示，术前CA125值升高、脉管浸润、特殊病理类型均是子宫内膜癌患者DFS 的独立危险因素。［结论］ 不同临床病理特征子宫内膜癌患者的PTEN、P53、MMR表达存在差异，PTEN、P53、MMR表达可用于评估患者预后。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the relationship of the PTEN， P53 and DNA mismatch repair (MMR) proteins expression with the pathological characteristics and prognosis in patients with endometrial cancer. ［Methods］ The clinical data of 118 patients with endometrial cancer who underwent comprehensive staged surgical treatment at Yuyao People’s Hospital from January 2018 to June 2022 were retrospective analyzed. According to the immunohistochemical results， patients were divided into PTEN mutation group， P53 mutation group， and deficient mismatch repair (dMMR) group， and the pathological characteristics and prognosis were compared among groups. The disease-free survival(DFS) curve was plotted by Kaplan-Meier method. The factors influencing the DFS of endometrial cancer patients was analyzed by the univariate Log-rank test and multivariate Cox proportional hazards regression. ［Results］ Among 118 patients， 85 cases(72.03%) had PTEN mutations， 30 cases (25.42%) had P53 mutations， and 30 cases (25.42%) had dMMR. There were significant differences in muscle infiltration， lymphatic vascular infiltration， lymph node metastasis， and special pathological types among the three groups (all P<0.05). The DSF of PTEN mutation group and non-mutation group were 72.02 months and 48.85 months， respectively (P<0.001)， the DFS of P53 non-mutation group and mutation group were 71.54 months and 43.21 months， respectively (P<0.001)， while there was no significant difference in DFS between dMMR group and non-dMMR group(P=0.450). There was a significant difference in DSF among PTEN mutation， P53 mutation， and dMMR groups(P<0.001). Univariate analysis showed that preoperative CA125 value and clinical high-risk pathological factors (G3， muscle infiltration>1/2， tumor size>2 cm， vascular infiltration， lymph node metastasis， special pathological types) had a significant impact on DFS in patients with endometrial cancer (all P<0.05). The Cox proportional hazards model showed that preoperative CA125 increase， vascular infiltration， and special pathological type were independent risk factors for DFS in endometrial cancer patients.［Conclusion］There are significant differences in the expression of PTEN， P53， and MMR among endometrial cancer patients with different clinicopathological characteristics. The expression of PTEN， P53 and MMR might be used to evaluate the prognosis of patients. |
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