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目的:探讨K-Ras和P53基因突变与子宫肌瘤发生和术后3年累积复发率的关系。方法:选取西宁市第一人民医院2008年6月至2010年6月收治的行子宫肌瘤剔除术的56例子宫肌瘤患者,分别取患者子宫肌瘤组织和正常子宫肌层组织,采用聚合酶链式反应-单链构象多态性分析(polymerase chain reaction-single strand conformation polymorphism analysis,PCR-SSCP)和基因测序方法进行K-Ras和P53基因突变的分析,并对K-Ras和P53基因突变子宫肌瘤患者术后3年累积复发率进行比较。结果:子宫肌瘤患者K-Ras基因突变以外显子1和2为主,P53基因突变以外显子7和8为主。与正常子宫肌层组织相比,子宫肌瘤组织K-Ras和P53基因单突变率以及双突变率均明显增加(73.21%vs 7.14%,83.93%vs 10.71%,32.14%vs 1.79%;均P<0.05)。K-Ras、P53单突变子宫肌瘤患者术后3年累积复发率分别为14.28%(6/42)和8.51%(4/47),双突变患者术后3年累积复发率为66.67%(12/18);双突变患者术后3年累积复发率明显高于单突变患者(P<0.05)。结论:K-Ras和P53基因突变可能是子宫肌瘤发生和术后复发的主要原因之一,可作为临床诊断和预后判断的指标。
Objective: To investigate the relationship between the mutations of K-Ras and P53 and the incidence of uterine fibroids and the cumulative recurrence rate after 3 years. Methods: Fifty-six patients with uterine fibroids who underwent myomectomy from June 2008 to June 2010 in Xining First People’s Hospital were enrolled. Uterine myoma and normal myometrium were collected from patients with myomectomy, K-Ras and P53 gene mutations were analyzed by polymerase chain reaction-single strand conformation polymorphism analysis (PCR-SSCP) and gene sequencing methods, and K-Ras and P53 gene Mutation uterine fibroids patients after 3 years of cumulative recurrence rates were compared. Results: K-Ras gene mutations in uterine fibroids are mainly exons 1 and 2, and exon 7 and 8 are the major mutations in P53 gene. Compared with the normal myometrium, the single mutation rate and double mutation rate of K-Ras and P53 in uterine myoma were significantly increased (73.21% vs 7.14%, 83.93% vs 10.71%, 32.14% vs 1.79%, P <0.05). The cumulative recurrence rates of K-Ras and P53 single-hysterectomy patients were 14.28% (6/42) and 8.51% (4/47) respectively after 3-year follow-up. The cumulative recurrence rates after 3-year double-mutation were 66.67% The cumulative recurrence rates of patients with double mutations after 3 years were significantly higher than those with single mutations (P <0.05). Conclusion: The mutations of K-Ras and P53 may be one of the main causes of uterine fibroids recurrence and postoperative recurrence, which can be used as an index for clinical diagnosis and prognosis.