Study on the relationship between gene mutation spectrum or HR-HPV infection and prognosis of cervical neuroendocrine carcinoma
Objective To investigate the prognostic value of gene mutation spectrum and high-risk human papillo-mavirus(HR-HPV)infection in neuroendocrine carcinoma of the uterine cervix(NECC).Methods This retrospective study included 79 patients with histologically confirmed NECC who were admitted to the gynecology department of the First Peo-ple's Hospital of Xianyang City from January 2016 to August 2023.They visited our hospital from January 2016 to August 2023.Molecular sequencing was performed on NECC tissue samples to record gene mutations.HR-HPV infection was de-tected by flow fluoro-liquid chip technique.The study endpoints were progression-free survival(PFS)and overall survival(OS).Results PIK3CA is the most common oncogenic mutation observed in this cohort(30.38％,24/79).Next are MYC(18.99％),TP53(16.46％,),KIT(13.92％),RB1(10.13％),and KRAS(3.80％).The positive rate of HR-HPV infection in NECC patients is 37.97％.The median follow-up time was 24.13(2.63 to 67.10)months.The median OS and PFS of 79 selected NECC patients were 42.7 and 38.1 months,respectively.By multiple factor Cox hazard analysis,RB1 mutation and positive HR-HPV infection can independently predict the PFS and OS prognosis of NECC patients(P＜0.05).Compared with patients with negative RB1 mutations,patients with positive RB1 mutations had lower progression free survival and overall survival rates,and shorter median PFS and median OS times,with significant differences(P＜0.05).Compared with patients with nega-tive HR-HPV infections,patients with positive HR-HPV infections had lower progression free survival rates and overall sur-vival rates,and shorter median PFS and median OS times,with significant differences(P＜0.05).According to the combined model of RB1 mutations and HR-HPV infections,NECC patients were classified as low-risk(RB1 mutations and HR-HPV infections were both negative).Medium risk(RB1 mutation negative and HR-HPV infection positive or RB1 mutation positive and HR-HPV infection negative)and high risk(RB1 mutation positive and HR-HPV infection positive).In the joint model,compared with low-risk patients,patients with medium to high risk had lower progression free survival and overall survival rates,and shorter median PFS and OS times(P＜0.05).Conclusion RB1 mutations and positive HR-HPV infection are associ-ated with an increased risk of poor prognosis in NECC,and are expected to serve as risk prediction tools for poor prognosis.
RB1 mutationHR-HPV infectionneuroendocrine carcinoma of the uterine cervixpoor prognosis
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