摘要
目的评估视网膜母细胞瘤基因1(RB1)和高危人乳头瘤病毒E6/E7 mRNA原位杂交(HR-HPV RNA in situ hybridization,RISH)预测子宫颈小细胞神经内分泌癌(SCNEC)预后不良的作用。方法选择了83例SCNEC的肿瘤标本作为研究对象,分析RB1和HR-HPV的表达情况,并使用COX模型和乘积极限法分析RB1与HR-HPV对SCNEC患者预后的影响。结果SCNEC肿瘤中有26例(31.33%)患者HR-HPV表达阳性,RB1阳性率为55.42%(46/83)。HR-HPV、RB1表达与肿瘤复发以及随访期间死亡相关(P<0.05)。在随访(4.70~68.27个月,中位数25.03个月)期间有45例(54.22%)患者病情进展,39例(46.99%)患者死亡。经COX单变量和多变量模型分析,HR-HPV阳性是患者疾病进展和死亡的临床独立危险因素(P<0.05),而RB1阳性是患者疾病进展和死亡的独立保护因素(P<0.05)。经Kaplan-Meier曲线分析,HR-HPV阳性的患者无进展生存期(PFS)(Log Rank=11.551,P=0.001)、总生存期(OS)(Log Rank=24.128,P<0.001)显著短于HR-HPV阴性的患者;RB1阳性的患者PFS(Log Rank=19.315,P<0.001)、OS(Log Rank=9.474,P=0.002)显著短于RB1阴性的患者;此外,在HR-HPV阳性和RB1阴性的患者中PFS(Log Rank=30.444,P<0.001)和OS(Log Rank=24.663,P<0.001)显著更低。结论在SCNEC患者中检测RB1以及HR-HPV RISH都是必要的,HR-HPV和RB1状态可以用于预测SCNEC患者的预后,特别是HR-HPV阳性和RB1阴性的患者预后最糟糕。
Objective To evaluate the role of retinoblastoma gene 1(RB1)and high-risk human papillomavirus E6/E7 mRNA in situ hybridization(HR-HPV RISH)in predicting the poor prognosis of cervical small cell neuroendocrine carcinoma(SCNEC).Methods Eighty-three tumor specimens of SCNEC were selected as the research subjects to analyze the expression of RB1 and HR-HPV,and the effects of RB1 and HR-HPV on the prognosis of SCNEC patients were analyzed by COX model and multiplication limit method.Results Twenty-six patients(31.33%)had positive HR-HPV expression in SCNEC tumors,and the positive rate of RB1 was 55.42%(46/83).The expression of HR-HPV and RB1 was associated with tumor recurrence and death during follow-up(P<0.05).During the median follow-up period of 25.03 months(4.70‒68.27 months),45 patients(54.22%)had disease progression and 39 patients(46.99%)died.The analysis of COX univariate and multivariate models showed that HR-HPV positivity was a clinically independent risk factor for disease progression and mortality(P<0.05),while RB1 positivity was an independent protective factor for disease progression and mortality(P<0.05).Kaplan-Meier curve analysis showed that the progression-free survival(PFS)(Log Rank=11.551,P=0.001)and overall survival(OS)(Log Rank=24.128,P<0.001)of HR-HPV-positive patients were significantly shorter than those of HR-HPV-negative patients,while the PFS(Log Rank=19.315,P<0.001)and OS(Log Rank=9.474,P=0.002)of RB1-positive patients were significantly shorter than that in RB1-negative patients.In addition,PFS(Log Rank=30.444,P<0.001)and OS(Log Rank=24.663,P<0.001)were significantly lower in HR-HPV-positive and RB1-negative patients.Conclusion It is necessary to detect RB1 and HR-HPV RISH in SCNEC patients,and HR-HPV and RB1 status can be used to predict the prognosis of SCNEC patients,especially the prognosis of HR-HPV-positive and RB1-negative patients is the worst.
作者
赵晓娟
魏珂
董菲
樊雅芝
张蕾
ZHAO Xiaojuan;WEI Ke;DONG Fei;FAN Yazhi;ZHANG Lei(Department of Gynecology,The First People’s Hospital of Xianyang,Xianyang,Shaanxi 712000,China)
出处
《中国优生与遗传杂志》
2024年第9期1856-1861,共6页
Chinese Journal of Birth Health & Heredity
基金
陕西中医药大学校管课题(2021FS01)。
