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

doi:10.3969/j.issn.1006-5725.2024.23.014

Abstract

Abstract:

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.

Key words: tumor lesion volume, uterine volume ratio, Ki-67 protein, p16 protein, endometrial cancer, pathological features, recrudescence

CLC Number:

R737.33

Liping CHEN,Juyu LUO,Zhangyan PENG,Xiulan WU,Yuhong YANG,Lianyan SHI,Xiaoyun LI,Ling. WANG. Correlation between the ratio of tumor volume to uterine volume and the expression of Ki⁃67 and p16 protein in tissues with the pathological features and recurrence of endometrial carcinoma[J]. The Journal of Practical Medicine, 2024, 40(23): 3367-3372.

Figures/Tables 4

Tab.1

Tab. 2

Fig.1

Tab. 3

References 26

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组别	例数	T/U		Ki-67蛋白		p16蛋白
组别	例数	≥ 0.18	< 0.18	阳性	阴性	阳性	阴性
复发组	28	17（60.71）	11（39.29）	15（53.57）	13（46.43）	12（42.86）	16（57.14）
非复发组	122	44（36.07）	78（63.93）	40（32.79）	82（67.21）	78（63.93）	44（36.07）
χ²值		5.734		4.236		4.215
P值		0.017		0.040		0.040

因素	T/U ≥ 0.18（n = 61）	T/U < 0.18（n = 89）	χ²值	P值	Ki-67阳性（n = 55）	Ki-67阴性（n = 95）	χ²值	P值	p16阳性（n = 90）	p16阴性（n = 60）	χ²值	P值
年龄			2.049	0.152			2.926	0.087			1.703	0.192
≥ 50岁	42（68.85）	51（57.3）			39（70.91）	54（56.84）			52（57.78）	41（68.33）
< 50岁	19（31.15）	38（42.7）			16（29.09）	41（43.16）			38（42.22）	19（31.67）
FIGO分期			11.594	0.001			8.422	0.004			4.768	0.029
Ⅰ+Ⅱ期	27（44.26）	64（71.91）			25（45.45）	66（69.47）			61（67.78）	30（50）
Ⅲ期	34（55.74）	25（28.09）			30（54.55）	29（30.53）			29（32.22）	30（50）
病理学分化程度			21.988	< 0.001			4.587	0.032			6.459	0.011
高+中分化	14（22.95）	55（61.8）			19（34.55）	50（52.63）			49（54.44）	20（33.33）
低分化	47（77.05）	34（38.2）			36（65.45）	45（47.37）			41（45.56）	40（66.67）
淋巴结转移			2.691	0.101			6.964	0.008			8.378	0.004
是	43（70.49）	51（57.3）			42（76.36）	52（54.74）			48（53.33）	46（76.67）
否	18（29.51）	38（42.7）			13（23.64）	43（45.26）			42（46.67）	14（23.33）
肌层浸润深度			2.215	0.137			3.704	0.054			2.79	0.095
≥ 1/2	37（60.66）	43（48.31）			35（63.64）	45（47.37）			43（47.78）	37（61.67）
< 1/2	24（39.34）	46（51.69）			20（36.36）	50（52.63）			47（52.22）	23（38.33）
累及宫颈			0.762	0.382			1.869	0.172			3.32	0.068
是	13（21.31）	14（15.73）			13（23.64）	14（14.74）			12（13.33）	15（25）
否	48（78.69）	75（84.27）			42（76.36）	81（85.26）			78（86.67）	45（75）

因素	β	SE	Walds	P值	OR	95%CI
FIGO分期	0.582	0.243	5.736	0.002	1.790	1.112 ~ 2.881
淋巴结转移	0.401	0.186	4.648	0.044	1.493	1.037 ~ 2.150
肌层浸润深度	0.397	0.171	5.390	0.018	1.487	1.064 ~ 2.080
T/U	0.518	0.207	6.262	< 0.001	1.679	1.119 ~ 2.519
Ki-67蛋白	0.476	0.225	4.476	0.046	1.610	1.036 ~ 2.502
p16蛋白	-0.500	0.268	3.481	0.097	0.607	0.359 ~ 1.026
常数项	1.409	0.840	2.814	0.125	4.092	0.789 ~ 21.230

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

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