Difference in Continuous Metabolic Syndrome Score and Its Correlation with Prognosis in Patients with p53 Wild-Type and Mutant Endometrial Cancer

YANG Xiaokun; CHEN Zhongping

doi:10.3969/j.issn.1004-437X.2025.22.019

Abstract：Objective To investigate the differences in continuous metabolic syndrome(cMetS)scores and their correlation with prognosis in patients with p53 wild-type and mutant endometrial cancer(EC).Methods A total of 199 EC patients admitted to Puyang People's Hospital from January 2020 to December 2023 were selected.Among them,there were 131 cases of p53 wild type and 68 cases of p53 mutant type.The cMetS scores were compared in p53 wild-type and mutant patients.The correlation between p53 type and cMetS score was analyzed using a point-biserial correlation analysis.All patients were divided into Q1,Q2,Q3,and Q4 groups according to the quartile of the cMetS score,and the clinical data of each group were compared.The survival prognosis analysis was conducted using the K-M curve.The effect of cMetS score on the prognosis of p53 wild-type and mutant EC patients was analyzed.Smooth curve fitting was used to analyzed the correlation between cMetS score and prognosis.The performance of the cMetS score in predicting prognosis was analyzed using receiver operating characteristic(ROC)curve.Results The cMetS score of p53 mutant patients was higher than that of wild-type patients(P＜0.05).Point-biserial correlation analysis showed that the p53 type was positively correlated with the cMetS score(P＜0.05).There were significant differences in International Federation of Gynecology and Obstetrics(FIGO)staging and p53 typing among Q1,Q2,Q3,and Q4 groups(P＜0.05).K-M curve analysis showed that the mortality rates in Q1,Q2,Q3,and Q4 groups showed an increasing trend,but Q3 and Q4 groups had higher mortality rates than Q1 and Q2 groups(P＜0.05).Cox regression analysis showed that the cMetS score was not associated with the prognosis of p53 wild-type EC patients(P＞0.05).After correcting for FIGO staging,the Q3 and Q4 groups were still associated with the prognosis of p53 mutant EC patients(P＜0.05).Smooth curve fitting showed that the cMetS score was positively correlated with prognosis in a nonlinear manner(Ptrend＜0.05,Pnonlinear＜0.05).Further RCS analysis showed that when the cMetS score was≤ 1.35,there was no correlation with prognosis(P＞0.05),and when the cMetS score was＞1.35,there was a positive correlation with prognosis(P＜0.05).The ROC curve was plotted and showed that the area under the curve(AUC)of the cMetS score prediction was 0.811(95％CI:0.695-0.838),with a cutoff value of 1.91,a sensitivity of 60.29％,and a specificity of 87.79％(P＜0.05).Conclusion Patients with p53 mutant EC are more likely to have metabolic abnormalities than wild-type patients.The cMetS score is a relevant prognostic factor for p53 mutant patients.When the cMetS score is greater than 1.35,the risk of poor prognosis increases gradually with increasing cMetS score,which helps predict the prognosis of EC and provides clinical guidance information.