肿瘤病灶体积与子宫体积比值和组织中Ki-67、p16蛋白表达与子宫内膜癌病理特征及复发的关联  

Correlation between the ratio of tumor volume to uterine volume and the expression of Ki⁃67 and p16 pro⁃tein in tissues with the pathological features and recurrence of endometrial carcinoma

作　　者：陈丽萍 罗菊玉 彭章艳 吴秀兰 杨宇宏 石连炎 李笑云 王灵 CHEN Liping;LUO Juyu;PENG Zhangyan;WU Xiulan;YANG Yuhong;SHI Lianyan;LI Xiaoyun;WANG Ling(Department of Gynecology,Qiandongnan Prefecture People's Hospital,Kaili 556000,Guizhou,China)

机构地区：[1]黔东南苗族侗族自治州人民医院妇科,贵州凯里556000 [2]黔东南苗族侗族自治州人民医院病理科,贵州凯里556000 [3]黔东南苗族侗族自治州人民医院重症医学科,贵州凯里556000

出　　处：《实用医学杂志》2024年第23期3367-3372,共6页The Journal of Practical Medicine

基　　金：贵州省科技支撑计划项目(编号:[2020]4Y139号)。

摘　　要：目的探讨肿瘤病灶体积与子宫体积比值(T/U)、病灶组织中Ki-67蛋白、p16蛋白表达与子宫内膜癌病理学特征及复发的关系。方法选取经黔东南州人民医院病理学检查证实的150例子宫内膜癌患者进行随访观察,其中有28例患者随访2年后出现复发,122例患者未出现复发,对比两组患者手术时T/U及病灶组织中Ki-67蛋白、p16蛋白表达差异,并按照不同病理学特征分别对比上述指标,并对比不同T/U、Ki-67蛋白、p16蛋白表达患者的无复发生存时间差异。结果复发组患者的T/U值、Ki-67蛋白阳性表达率均显著高于非复发组,p16蛋白阳性表达率显著低于非复发组,差异有统计学意义(P<0.05);T/U≥0.18的子宫内膜癌患者中Ⅲ期患者占比、组织学低分化患者占比均显著高于T/U<0.18的子宫内膜癌患者,差异有统计学意义(P<0.05);Ki-67蛋白阳性表达的子宫内膜癌患者中Ⅲ期患者占比、组织学低分化患者占比、发生淋巴结转移的患者占比均显著高于Ki-67蛋白阴性表达的子宫内膜癌患者,差异有统计学意义(P<0.05);p16蛋白阳性表达的子宫内膜癌患者中Ⅲ期患者占比、组织学低分化患者占比、发生淋巴结转移的患者占比均显著低于p16蛋白阴性表达的子宫内膜癌患者,差异有统计学意义(P<0.05)。T/U≥0.18的子宫内膜癌患者术后2年无复发生存时间短于T/U<0.18的患者(χ^(2)=6.962,P=0.008);Ki-67阳性表达的子宫内膜癌患者术后2年无复发生存时间短于Ki-67阴性表达的患者(χ^(2)=4.815,P=0.028);p16蛋白阳性表达的子宫内膜癌患者术后2年无复发生存时间长于p16蛋白阴性表达的患者(χ^(2)=4.279,P=0.039)。FIGO分期为Ⅲ期、发生淋巴结转移、肌层浸润深度≥1/2、T/U值≥0.18、Ki-67蛋白阳性表达是子宫内膜癌手术后复发的危险因素(P<0.05);p16蛋白阳性表达是子宫内膜癌手术后复发的保护性因素(P<0.05)。结论子宫内膜癌患者T/U、Ki-67蛋白�Objective To investigate the correlation between the ratio of lesion volume to uterine volume(T/U),the expression levels of Ki-67 and p16 proteins in lesion tissue,and the recurrence risk of endometrial cancer.Methods A total of 150 patients diagnosed with endometrial carcinoma through pathological examination at Qiandongnan Prefecture People's Hospital were enrolled for follow-up observation.Among them,28 patients experienced recurrence after a 2-year follow-up period,while 122 patients remained recurrence-free.The expression differences of Ki-67 protein and p16 protein in T/U and lesion tissues during surgery were compared between the two groups.Furthermore,these indexes were analyzed based on different pathological features,and the variation in relapse-free survival time was assessed among patients with distinct T/U status as well as Ki-67 and p16 protein expressions.Results The T/U value and the positive expression rate of Ki-67 protein were significantly higher in the relapsed group compared to the non-relapsed group,while the positive expression rate of p16 protein was significantly lower in the relapsed group(P<0.05).Additionally,patients with T/U≥0.18 had a significantly higher proportion of stageⅢpatients and patients with low histological differentiation compared to those with T/U<0.18(P<0.05).Furthermore,patients with positive expression of Ki-67 protein exhibited a significantly higher proportion of stageⅢpatients,patients with low histological differentiation,and lymph node metastasis compared to those with negative expression of Ki-67 protein(P<0.05).The proportion of stageⅢpatients exhibiting positive p16 protein expression,low histological differentiation,and lymph node metastasis was significantly lower compared to those with negative p16 protein expression(P<0.05).Patients with endometrial cancer having a T/U≥0.18 experienced shorter recurrence-free survival time 2 years post-surgery in comparison to patients with T/U<0.18(χ^(2)=6.962,P=0.008).Patients displaying positive Ki-67 expres

关 键 词：肿瘤病灶体积 子宫体积比值 Ki-67蛋白 P16蛋白 子宫内膜癌 病理学特征 复发 

分 类 号：R737.33[医药卫生—肿瘤]