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血脂异常与p53突变型在子宫内膜癌中的相关性研究

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目的 探讨子宫内膜癌患者中血脂异常情况及血脂异常与p53突变型子宫内膜癌发病风险的相关性。方法 收集2019年11月至2024年4月就诊于滨州医学院附属医院,术前未行任何相关治疗且术后病理确诊为子宫内膜癌的患者共136例,其中p53野生型64例,p53突变型72例。收集入院首次空腹大生化的血脂情况进行单因素分析,将有统计学意义的因素再纳入多因素logistic回归分析,并绘制受试者操作特征曲线(ROC);收集患者术后病理参数,分析其与p53突变型子宫内膜癌之间的关系。采用t检验、Mann-Whitney U检验、x2检验进行统计比较。结果 p53突变型子宫内膜癌组的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)水平高于p53野生型子宫内膜癌组,差异均有统计学意义(均 P<0。05);纳入二元 logistic 回归分析,TC:OR=0。959,95%CI 0。253~3。757,P=0。952,TG:OR=1。398,95%CI 0。703~2。965,P=0。357,低密度脂蛋白(LDL):OR=8。205,95%CI 1。472~50。567,P=0。019,HDL:OR=2。252,95%CI 0。373~14。255,P=0。378。ROC 分析 LDL预测发生 p53 突变型子宫内膜癌的灵敏度为0。828,特异度为0。792,最佳截断值为2。41 mmol/L,曲线下面积为0。843。p53野生型与突变型子宫内膜癌在分期、组织分化程度、淋巴转移方面差异均有统计学意义(均P<0。05),但在肌层浸润深度方面差异无统计学意义(P>0。05)。结论 LDL是p53突变型子宫内膜癌的危险因素,预测价值较高,且p53突变型子宫内膜癌预后较差,有望成为预测子宫内膜癌分型和恶性程度的指标。
Correlation between dyslipidemia and p53 mutation in endometrial cancer
Objective To explore the incidence of dyslipidemia in patients with endometrial cancer and the correlation between dyslipidemia and the risk of p53 mutant endometrial cancer.Methods A total of 136 patients who underwent no preoperative treatment and were pathologically diagnosed with endometrial cancer after surgery at Binzhou Medical University Hospital from November 2019 to April 2024 were selected,including 64 cases of wild-type p53 and 72 cases of p53 mutation.The blood lipid levels were collected during their first fasting period at admission for the univariate analysis.The statistically significant factors were included in the multivariate logistic regression analysis.The receiver operating characteristic curve(ROC)was drawn.The patients'postoperative pathological parameters,depth of myometrial infiltration,staging,degree of tissue differentiation,and lymph node metastasis,were collected;their relationship with p53 mutant endometrial cancer was analyzed.t test,Mann-Whitney U test and x2 test were used for statistical comparison.Results The level of TC,TG,LDL,and HDL in the p53 mutant endometrial cancer group were higher than those in the p53 wild-type endometrial cancer group,with statistical differences(all P<0.001).The inclusion of binary logistic regression analysis resulted in TC(OR=0.959,95%CI 0.253-3.757,P=0.952),TG(OR=1.398,95%CI 0.703-2.965,P=0.357),LDL(OR=8.205,95%CI 1.472-50.567,P=0.019),and HDL(OR=2.252,95%CI 0.373-14.255,P=0.378).The ROC analysis showed that the sensitivity of LDL in predicting the occurrence of p53 mutant endometrial cancer was 0.828;the specificity was 0.792;the optimal cutoff value was 2.41;the area under the curve(AUC)was 0.843.There were statistical differences in staging,tissue differentiation,and lymph node metastasis(all P<0.05)but no statistical difference in the depth of muscle infiltration(P>0.05)between wild-type and mutant p53 endometrial cancer.Conclusions LDL is a risk factor for developing p53 mutant endometrial cancer,with high predictive value.Moreover,the prognosis of patients with p53 mutant endometrial cancer is poor.LDL is expected to become an indicator for predicting the classification and malignancy of endometrial cancer.

Endometrial cancerDyslipidemiap53 mutant typeMalignant degree

刘伟龙、么童童、胡瑞琦、石洪堂、陈迎港、刘志强

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滨州医学院附属医院妇产科,滨州 256603

子宫内膜癌 血脂异常 p53突变型 恶性程度

山东省自然科学基金

ZR202111300484

2024

国际医药卫生导报
中华医学会,国际医药卫生导报社

国际医药卫生导报

影响因子:0.781
ISSN:1007-1245
年,卷(期):2024.30(19)