原发性TP53突变型胃癌的病理特征及患者预后的影响因素  

Clinical Pathological Characteristics and Prognostic Impact of Primary TP53 Mutated Gastric Cancer

作　　者：季成栋 陆夏良 赵婉君 JI Chengdong;LU Xialiang;ZHAO Wanjun(Department of Pathology,the Ninth People's Hospital of Suzhou,Suzhou Jiangsu 215200)

机构地区：[1]苏州市第九人民医院病理科,江苏苏州215200

出　　处：《医学临床研究》2025年第2期193-196,共4页Journal of Clinical Research

摘　　要：【目的】探讨原发性TP53突变型胃癌患者的临床病理特征及患者预后的影响因素。【方法】回顾性分析68例TP53突变型胃癌患者(突变组)和102例TP53野生型胃癌患者(野生型组)的临床资料,比较两组患者的临床病理特征。采用Kaplan-Meier法绘制生存曲线,并用Log-rank检验比较两组的总生存期(OS)和无病生存期(DFS),通过单因素分析和Cox回归模型影响胃癌患者预后的独立因素。【结果】突变组患者年龄≥55岁、低分化肿瘤、TNM分期晚期(Ⅲ+Ⅳ期)、伴有淋巴结转移及肿瘤直径较大的比例明显高于野生型组(P<0.05)。生存分析显示,TP53突变组患者的3年总生存率、无病生存率均显著低于野生型组(P<0.05)。单因素Cox回归分析表明,分化程度、TNM分期、淋巴结转移、肿瘤直径、TP53突变是胃癌预后的不良因素;多因素Cox回归分析表明,年龄大、分化程度低、TNM分期晚期、淋巴结转移、肿瘤直径较大、TP53突变是胃癌预后不良的独立危险因素。【结论】TP53突变型胃癌患者具有较差的预后,年龄、分化程度、TNM分期、淋巴结转移、肿瘤直径及TP53突变是其独立的预后危险因素。【Objective】To investigate the clinical pathological characteristics and prognostic impact of patients with primary TP53 mutated gastric cancer.【Methods】This retrospective study analyzed the clinical data of 68 patients with TP53 mutated gastric cancer(mutation group)and 102 patients with TP53 wild-type gastric cancer(wild-type group).The clinical pathological characteristics of the two groups were compared.Survival curves were plotted using the Kaplan-Meier method,and overall survival(OS)and disease-free survival(DFS)were compared using the Log-rank test.Univariate analysis and Cox regression models were employed to explore the independent factors affecting the prognosis of gastric cancer patients.【Results】Patients in the mutation group with age≥55 a significantly higher proportion of poorly differentiated tumors,advanced(StageⅢ+Ⅳ)TNM staging,lymph node metastasis,and larger tumor size compared to the wild-type group(P<0.05).Survival analysis showed that the 3-year OS and DFS rates of the TP53 mutation group were significantly lower than those of the wild-type group(P<0.05).Univariate Cox regression analysis indicated that differentiation degree,TNM stage,lymph node metastasis,tumor diameter,and TP53 mutation were adverse prognostic factors for gastric cancer;multivariate Cox regression analysis revealed that age,differentiation degree,TNM stage,lymph node metastasis,tumor diameter,and TP53 mutation were independent risk factors for poor prognosis in gastric cancer.【Conclusion】Patients with TP53 mutated gastric cancer exhibit poorer clinical characteristics and prognosis.Age,differentiation degree,TNM stage,lymph node metastasis,tumor diameter,and TP53 mutation are independent prognostic risk factors.

关 键 词：基因 p53 胃肿瘤 病理状态 体征和症状 预后 

分 类 号：R735.2[医药卫生—肿瘤]