摘要
目的探讨结直肠癌错配修复(MMR)蛋白表达和微卫星不稳定(MSI)与肿瘤TNM分期的相关性。方法回顾性分析2008年1月至2017年12月在空军军医大学西京消化病医院行结直肠癌根治术的1 351例患者的临床资料。分析不同性别、年龄及TNM分期患者MMR蛋白表达和MSI情况。结果 1 351例中,291例(22%)MMR蛋白表达缺失。单因素分析结果显示,年龄≥60岁与<60岁患者间MSH2、MSH6、PMS2缺失率比较,差异均有统计学意义(均P<0.05);T3期亚组MSH2缺失率与其他T分期亚组比较,差异有统计学意义(P<0.05);各N分期亚组间MLH1、PMS2缺失率比较,差异均有统计学意义(均P<0.05);N0和N1期亚组MSH2、MSH6缺失率与其他N分期亚组比较,差异均有统计学意义(均P<0.05);各M分期亚组间PMS2缺失率比较,差异有统计学意义(均P<0.05);各TNM分期亚组间PMS2缺失率比较,差异均有统计学意义(均P<0.05);TNM分期Ⅱ期、Ⅲ期亚组MLH1、MSH2、MSH6缺失率与其他TNM分期亚组比较,差异均有统计学意义(均P<0.05)。年龄≥60岁与<60岁患者MSI阳性率比较,差异有统计学意义(P<0.05);T3期亚组、T4期亚组、各N分期亚组间、各M分期亚组间及TNM分期Ⅱ期、Ⅲ期和Ⅳ期亚组MSI阳性率比较,差异均有统计学意义(均P<0.05)。结论结直肠癌患者MMR蛋白表达和MSI与肿瘤TNM分期密切相关,检测结直肠癌患者MMR蛋白表达和MSI对判断结直肠癌TNM分期有一定的参考价值,并可能指导结直肠癌患者的诊疗及判断预后。
Objective To investigate the relationship between mismatch repair (MMR) protein expression and microsatellite instability (MSI) and tumor TNM staging in colorectal cancer. Methods The clinical data of 1 351 patients who underwent radical resection of colorectal cancer at the Xijing Digestive Hospital of Air Force Military Medical University from January 2008 to December 2017 were retrospectively analyzed. The MMR and MSI status in patients with different gender, age and TNM staging were analyzed. Results Of the 1 351 specimens, 291 (22%) didn't express MMR protein. Univariate analysis showed that there were significant differences in the deletion rates of MSH2, MSH6 and PMS2 between patients ≥ 60 years old and < 60 years old (all P < 0.05);there were significant differences in the deletion rates of MSH2 between stage T3 and the other stages (P < 0.05);the deletion rates of MLH1, PMS2 among different N stages, and the deletion rates of MSH2 and MSH6 between stage N0 or N1 and the other N stages were significantly different (all P < 0.05);the deletion rates of PMS2 among different M stages were significantly different (P < 0.05). There were significant differences in PMS2 deletion rates among different TNM stages and MLH1, MSH2 and MSH6 deletion rates between stage Ⅱ or Ⅲ and the other stages (all P < 0.05). There was significant difference in MSI positive rates between patients ≥ 60 years old and < 60 years old (P < 0.05);there were significant differences in MSI positive rates between stage T3 or T4 and the other T stages, among different N or M stages, and between TNM stage Ⅱ,Ⅲ or Ⅳ and the other TNM stages (all P < 0.05). Conclusions The MMR protein expression and MSI in colorectal cancer patients are closely related to tumor TNM staging. Detection of MMR protein expression and MSI in colorectal cancer patients has certain reference value for judging TNM staging of colorectal cancer. To a certain extent, it can guide the diagnosis and treatment of patients with colorectal cancer and judge the prognosis.
作者
郭源
张龙
张舜
余彦平
吕勇志
李纪鹏
Guo Yuan;Zhang Long;Zhang Shun;Yu Yanping;Lyu Yongzhi;Li Jipeng(Graduate School, Xi'an Medical University, Xi'an 710068, China;Department of Digestive Surgery, Xijing Digestive Hospital of Air Force Military Medical University, Xi'an 710032, China)
出处
《肿瘤研究与临床》
CAS
2019年第6期376-380,共5页
Cancer Research and Clinic
