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（χ² = 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（χ² = 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（χ² = 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蛋白和p16蛋白表达与肿瘤发生发展有一定的关系，可能会增大患者手术后复发的风险。

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 stage Ⅲ patients 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 stage Ⅲ patients， 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 stage Ⅲ patients 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 （χ² = 6.962， P = 0.008）. Patients displaying positive Ki-67 expression had a shorter recurrence-free survival time 2 years after surgery than those with negative Ki-67 expression （χ² = 4.815， P = 0.028）. The recurrence-free survival time 2 years after surgery for patients expressing p16 protein positively was longer than that for patients expressing it negatively （χ² = 4.279， P = 0.039）. The presence of FIGO stage Ⅲ， lymph node metastasis， depth of myographic invasion ≥1/2， T/U value ≥ 0.18， and positive expression of Ki-67 protein were identified as significant risk factors for postoperative recurrence in endometrial cancer （P < 0.05）. Conversely， the positive expression of p16 protein was found to be a protective factor against recurrence in endometrial carcinoma following surgery （P < 0.05）. Conclusion The expression of T/U， Ki-67 protein， and p16 protein in endometrial cancer patients is associated with tumor progression and may augment the risk of postoperative recurrence.