微卫星不稳定结直肠癌临床病理特征及生存预后
发布时间：2018-08-24 16:05
【摘要】：目的国内外已有学者提出微卫星不稳定(microsatellite instability,MSI)状态可能是影响结直肠癌(colorectal cancer,CRC)患者预后的因素,同时提出微卫星不稳定结直肠癌患者存在较为特殊的临床病理特征,本研究旨在探讨微卫星不稳定CRC的临床病理特征及生存预后。方法应用免疫组织化学方法检测2010-03-24-2015-12-24济南市第四人民医院60例CRC组织中人MutL蛋白同系物1(human mutl homologue 1,hMLH1)、人MutS蛋白同系物2(human muts homologue 2,hMSH2)及人MutS蛋白同系物6(human muts homologue 6,hMSH6)3种DNA错配修复蛋白表达缺失情况,判断肿瘤微卫星不稳定状态,并分析高度微卫星不稳定(microsatellite instability-high,MSI-H)和低度微卫星不稳定(microsatellite instability-low,MSI-L)/微卫星稳定(microsatellite stable,MSS)不同组别间的临床病理特征及生存预后情况;应用Cox风险比例模型对可能影响CRC患者预后的因素进行多因素分析。结果 60例CRC患者的肿瘤组织中MSI-H为40.0%(24/60),MSI-L为31.7%(19/60),MSS为28.3%(17/60)。MSI-H的CRC患者,与MSS和MSI-L患者相比,好发于右半结肠(χ~2=6.279,P=0.043),黏液腺癌多见(χ~2=6.025,P=0.049);3组在性别、年龄、分期、肿瘤浸润深度、淋巴结转移和分化程度差异无统计学意义。MSI-H患者的中位无病生存期(disease-free survival,DFS)为21个月,明显长于MSS的11个月及MSI-L的13个月,χ~2=7.994,P=0.018。多因素Cox分析结果显示,淋巴结转移(P=0.013)和MSI(P=0.018)为CRC患者DFS的独立预后因素。结论 MSI-H的CRC患者与MSI-L及MSS相比,具有独特的临床病理特征且预后相对较好。检测MSI状态对提高CRC治疗水平,及改善预后有重要的临床意义。
[Abstract]:Objective some scholars at home and abroad have suggested that microsatellite instability (microsatellite instability,MSI) may be the prognostic factor in patients with colorectal cancer (colorectal cancer,CRC), and that microsatellite instability has special clinicopathological features. The aim of this study was to investigate the clinicopathological features and survival prognosis of microsatellite unstable CRC. Methods Immunohistochemical method was used to detect three kinds of DNA mismatch repair in 60 cases of CRC tissues in Jinan fourth people's Hospital 2010-03-24-2015-12-24 (1 (human mutl homologue / hMLH1), 2 (human muts homologue 2hMSH2) and 6 (human muts homologue 6hMSH6). Loss of protein expression, The tumor microsatellite instability status was evaluated and the clinicopathological features and survival prognosis of different groups of high microsatellite instability (microsatellite instability-high,MSI-H) and low degree microsatellite instability (microsatellite instability-low,MSI-L) / microsatellite stability (microsatellite stable,MSS) were analyzed. Cox risk ratio model was used to analyze the factors that may affect the prognosis of CRC patients. Results in 60 patients with CRC, 40.0% (24 / 60) of MSI-H (24 / 60) with MSI-L was 31.7% (19 / 60). MSI-H was 28.3% (17 / 60) .MSI-H was more common in the right hemicolon than in MSS and MSI-L (蠂 ~ 26.279P0.043), and mucinous adenocarcinoma was more common in sex, age, stage, depth of tumor infiltration, The median disease-free survival (disease-free survival,DFS) of patients with MSI-H was 21 months, which was significantly longer than that of 11 months of MSS and 13 months of MSI-L. Multivariate Cox analysis showed that lymph node metastasis (P0. 013) and MSI (P0. 018) were independent prognostic factors of DFS in CRC patients. Conclusion compared with MSI-L and MSS, CRC patients with MSI-H have unique clinicopathological features and better prognosis. Detection of MSI status is of great clinical significance in improving the treatment level and prognosis of CRC.
【作者单位】： 济南市第四人民医院消化内科;济南市第四人民医院肿瘤科;济南市第四人民医院病理科;
【分类号】：R735.34
[Abstract]:Objective some scholars at home and abroad have suggested that microsatellite instability (microsatellite instability,MSI) may be the prognostic factor in patients with colorectal cancer (colorectal cancer,CRC), and that microsatellite instability has special clinicopathological features. The aim of this study was to investigate the clinicopathological features and survival prognosis of microsatellite unstable CRC. Methods Immunohistochemical method was used to detect three kinds of DNA mismatch repair in 60 cases of CRC tissues in Jinan fourth people's Hospital 2010-03-24-2015-12-24 (1 (human mutl homologue / hMLH1), 2 (human muts homologue 2hMSH2) and 6 (human muts homologue 6hMSH6). Loss of protein expression, The tumor microsatellite instability status was evaluated and the clinicopathological features and survival prognosis of different groups of high microsatellite instability (microsatellite instability-high,MSI-H) and low degree microsatellite instability (microsatellite instability-low,MSI-L) / microsatellite stability (microsatellite stable,MSS) were analyzed. Cox risk ratio model was used to analyze the factors that may affect the prognosis of CRC patients. Results in 60 patients with CRC, 40.0% (24 / 60) of MSI-H (24 / 60) with MSI-L was 31.7% (19 / 60). MSI-H was 28.3% (17 / 60) .MSI-H was more common in the right hemicolon than in MSS and MSI-L (蠂 ~ 26.279P0.043), and mucinous adenocarcinoma was more common in sex, age, stage, depth of tumor infiltration, The median disease-free survival (disease-free survival,DFS) of patients with MSI-H was 21 months, which was significantly longer than that of 11 months of MSS and 13 months of MSI-L. Multivariate Cox analysis showed that lymph node metastasis (P0. 013) and MSI (P0. 018) were independent prognostic factors of DFS in CRC patients. Conclusion compared with MSI-L and MSS, CRC patients with MSI-H have unique clinicopathological features and better prognosis. Detection of MSI status is of great clinical significance in improving the treatment level and prognosis of CRC.
【作者单位】： 济南市第四人民医院消化内科;济南市第四人民医院肿瘤科;济南市第四人民医院病理科;
【分类号】：R735.34
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