基于TCGA数据库的子宫内膜癌不良预后预测模型构建  

Construction of Poor Prognosis Prediction Model for Endometrial Cancer Based on TCGA Database

作　　者：卢琴琴 黄玉秀[2] 陈兰钦 LU Qinqin;HUANG Yuxiu;CHEN Lanqin(Department of Obstetrics and Gynecology,Pingtan Comprehensive Experimental Zone Hospital,Fuzhou 350400,China;Department of Gynecology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350000,China)

机构地区：[1]平潭综合实验区医院妇产科,福州350400 [2]福建医科大学附属第一医院妇科,福州350000

出　　处：《医学综述》2025年第7期893-896,F0003,共5页Medical Recapitulate

摘　　要：目的基于癌症基因组图谱(TCGA)数据库构建子宫内膜癌不良预后预测模型。方法从TCGA数据库中下载并整理445例子宫内膜癌患者的临床资料以及生存资料,利用单因素分析筛选子宫内膜癌患者生存相关病理特征,采用多因素Logistic回归分析确定子宫内膜癌患者不良预后相关病理特征,采用受试者工作特征曲线(ROC)分析该模型预测患者不良预后的准确性。结果445例子宫内膜癌患者中410例存活,35例死亡。单因素分析结果显示,年龄≥60岁、病理分期为Ⅲ期+Ⅳ期、组织学分级为G3、病理类型为混合癌+浆液性癌+未分化癌患者死亡率高于年龄<60岁、病理分期为Ⅰ期+Ⅱ期、组织学分级为G1+G2、病理类型为子宫内膜样癌的患者(P<0.05或P<0.01),发生子宫深肌层浸润、宫颈间质浸润、淋巴血管间隙侵犯、淋巴结转移、子宫外侵犯的死亡率高于未发生子宫深肌层浸润、宫颈间质浸润、淋巴血管间隙侵犯、淋巴结转移、子宫外侵犯的患者(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,年龄≥60岁、病理类型为非子宫内膜样癌、发生子宫深肌层浸润、发生淋巴血管间隙侵犯是子宫内膜癌患者发生不良预后的独立危险因素(OR=2.776,95%CI 1.373~5.611;OR=2.622,95%CI 1.360~5.056;OR=2.875,95%CI 1.197~6.904;OR=3.047,95%CI 1.490~6.230)(P<0.05或P<0.01)。Logistic回归模型预测子宫内膜癌患者不良预后的ROC曲线下面积为0.893,灵敏度为0.743,特异度为0.980。结论基于年龄、发生深肌层浸润、非子宫内膜样癌以及淋巴血管间隙侵犯病理特征的子宫内膜癌患者不良预后预测模型,可为临床预测子宫内膜癌患者不良预后及采取综合干预方案提供数据支持。Objective To construct a prediction model of poor prognosis of endometrial cancer based on the cancer genome atlas(TCGA)database.Methods The clinical data and survival data of 445 endometrial cancer patients were downloaded and collated from TCGA database.Univariate analysis was utilized to screen out the survival-related pathological features of the patients.Multivariate logistic regression analysis was adopted to determine the poor prognosis-related pathological features of the patients.Receiver operating characteristic(ROC)curve analysis was constructed to analyze the accuracy of the prediction model on poor prognosis.Results Among the 445 patients,410 cases survived and 35 cases died.The results of univariate analysis showed that the mortality rates of the patients aged≥60 years,pathological stage Ⅲ+Ⅳ,histological grade G3,pathological type mixed carcinoma+serous carcinoma+undifferentiated carcinoma were higher than those of the patients aged<60 years,pathological stage Ⅰ+Ⅱ,histological grade G1+G2,pathological type endometrioid carcinoma(P<0.05 or P<0.01).The mortality rates of the patients with deep uterine invasion,cervical interstitial invasion,invasion of lymphovascular space,lymph node metastasis,and extrauterine invasion were higher than those of the patients without deep uterine invasion,cervical interstitial invasion,invasion of lymphovascular space,lymph node metastasis,and extrauterine invasion(P<0.05 or P<0.01).Multivariate Logistic regression analysis found that age≥60 years,pathological type of non-endometrioid cancer,deep myometrial invasion and lymphovascular space invasion were independent risk factors affecting the poor prognosis of endometrial cancer patients(OR=2.776,95%CI 1.373-5.611;OR=2.622,95%CI 1.360-5.056;OR=2.875,95%CI 1.197-6.904;OR=3.047,95%CI 1.490-6.230)(P<0.05 or P<0.01).The area under the ROC curve of Logistic regression model for predicting poor prognosis of patients with endometrial cancer was 0.893,the sensitivity was 0.743 and the specificity was 0.980.Conclusi

关 键 词：子宫内膜癌 癌症基因组图谱数据库 病理因素 预后 

分 类 号：R737.33[医药卫生—肿瘤]