摘要
目的探讨免疫组化标志物p53在Ⅰ~Ⅱ期子宫内膜癌中的阳性表达百分比临界值及其预后价值。方法选取2013年10月至2018年5月于重庆医科大学附属第一医院接受手术治疗的323例Ⅰ~Ⅱ期子宫内膜癌患者。运用单因素及多因素Cox回归模型分析与子宫内膜癌复发相关的独立预后因素,受试者工作特征曲线及约登指数确定p53用于预测子宫内膜癌复发的最佳阳性百分比临界值,最后利用logistic回归模型构建基于p53的预测模型。结果单因素及多因素分析提示p53是Ⅰ~Ⅱ期子宫内膜癌复发独立影响因素,且p53最佳阳性表达百分比临界值为67.5%,在此基础上成功构建logistic回归预测模型,即Ln[P/(1-P)]=-3.281+1.138X1+1.050X2+1.322X3-0.725X4+0.029X5-0.015X6+1.408X7(P表示患者复发概率;X1~X7分别表示病理分型、肌层浸润、子宫颈间质浸润、术后辅助治疗、Ki67、雌激素受体(ER)、p53的状态或阳性百分比值)。结论免疫组化指标p53预测Ⅰ~Ⅱ期子宫内膜癌复发的最佳阳性表达百分比阈值为67.5%,基于p53构建的logistic回归预测模型可以更好的对患者进行预后管理。
Objective To explore the threshold of positive percentage of immunohistochemical marker p53 in stageⅠ-Ⅱendometrial cancer and its prognostic value.Methods A total of 323 patients with stageⅠ-Ⅱendometrial cancer who received primary surgical treatment in the First Affiliated Hospital of Chongqing Medical University from October 2013 to May 2018 were selected.Univariate and multivariate Cox regression models were used to analyze the independent prognostic factors related to endometrial cancer recurrence.The receiver operating characteristic curve and Youden index were used to determine the optimal threshold of positive percentage of p53 for predicting endometrial cancer recurrence.Finally,the logistic regression model was used to build a prediction model based on p53.Results Univariate and multivariate analysis suggested that p53 was an independent influencing factor associated with the recurrence of stageⅠ-Ⅱendometrial cancer,and the optimal threshold of positive percentage of p53 was 67.5%.On this basis,a logistic regression prediction model was successfully constructed.Conclusion The optimal threshold of positive percentage of p53 to predict the recurrence of stageⅠ-Ⅱendometrial cancer is 67.5%.The logistic regression prediction model based on p53 can better manage the prognosis of patients.
作者
易倩琳
蒋鹏
朱梦秋
肖琳
YI Qian-lin;JIANG Peng;ZHU Meng-qiu;XIAO Lin(Department of Gynecology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2023年第5期568-572,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
重庆市科卫联合医学科研项目(2023MSXM116)。
