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 explore the relationship of K-Ras and P53 gene mutation with development and postoperative recurrence of hysteromyoma. Methods: Fifty-six patients with hysteromyoma undergoing myomectomy were selected from First People Hospital of Xining during June 2008 to June 2010. The hysteromyoma tissues and normal uterus tissues were obtained from patients. K-Ras and P53 gene mutations were analyzed by polymerase chain reaction-single strand conformation polymorphism analysis (PCR-SSCP) and gene sequencing. The postoperative recurrence rate after uterine fibroid surgery in patients with K-Ras and P53 gene mutation was analyzed. Results: K-Ras gene mutation was focused on exon 1 and 2. P53 gene mutation was focused on exon 7 and 8. The mutation rate of K-Ras and P53 and the double mutation rate in the hysteromyoma tissues were significantly increased when compared with those in the normal uterus tissues (73.21% vs 7.14%, 8393% vs 10.71%, 32.14% vs 1.79%, P<0.05). Postoperative 3-year cumulative recurrence rates were 14.28% (6/42) and 8.51% (4/47) in the hysteromyoma patients with K-Ras or P53 mutation. Postoperative 3-year cumulative recurrence rate in the patients with double mutation was 66.67% (12/18), which was significantly higher than that in patients with single mutation (P<0.05). Conclusion: K-Ras and P53 gene mutations may be one of the main reasons leading to the occurrence and postoperative recurrence of hysteromyoma, which can be indicators for clinical diagnosis and prognosis.

青海省科研基金资助项目（No.963211Y0141）