微衛(wèi)星不穩(wěn)定結(jié)直腸癌臨床病理特征及生存預(yù)后
發(fā)布時間：2018-08-24 16:05
【摘要】：目的國內(nèi)外已有學(xué)者提出微衛(wèi)星不穩(wěn)定(microsatellite instability,MSI)狀態(tài)可能是影響結(jié)直腸癌(colorectal cancer,CRC)患者預(yù)后的因素,同時提出微衛(wèi)星不穩(wěn)定結(jié)直腸癌患者存在較為特殊的臨床病理特征,本研究旨在探討微衛(wèi)星不穩(wěn)定CRC的臨床病理特征及生存預(yù)后。方法應(yīng)用免疫組織化學(xué)方法檢測2010-03-24-2015-12-24濟南市第四人民醫(yī)院60例CRC組織中人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種DNA錯配修復(fù)蛋白表達缺失情況,判斷腫瘤微衛(wèi)星不穩(wěn)定狀態(tài),并分析高度微衛(wèi)星不穩(wěn)定(microsatellite instability-high,MSI-H)和低度微衛(wèi)星不穩(wěn)定(microsatellite instability-low,MSI-L)/微衛(wèi)星穩(wěn)定(microsatellite stable,MSS)不同組別間的臨床病理特征及生存預(yù)后情況;應(yīng)用Cox風(fēng)險比例模型對可能影響CRC患者預(yù)后的因素進行多因素分析。結(jié)果 60例CRC患者的腫瘤組織中MSI-H為40.0%(24/60),MSI-L為31.7%(19/60),MSS為28.3%(17/60)。MSI-H的CRC患者,與MSS和MSI-L患者相比,好發(fā)于右半結(jié)腸(χ~2=6.279,P=0.043),黏液腺癌多見(χ~2=6.025,P=0.049);3組在性別、年齡、分期、腫瘤浸潤深度、淋巴結(jié)轉(zhuǎn)移和分化程度差異無統(tǒng)計學(xué)意義。MSI-H患者的中位無病生存期(disease-free survival,DFS)為21個月,明顯長于MSS的11個月及MSI-L的13個月,χ~2=7.994,P=0.018。多因素Cox分析結(jié)果顯示,淋巴結(jié)轉(zhuǎn)移(P=0.013)和MSI(P=0.018)為CRC患者DFS的獨立預(yù)后因素。結(jié)論 MSI-H的CRC患者與MSI-L及MSS相比,具有獨特的臨床病理特征且預(yù)后相對較好。檢測MSI狀態(tài)對提高CRC治療水平,及改善預(yù)后有重要的臨床意義。
[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.
【作者單位】： 濟南市第四人民醫(yī)院消化內(nèi)科;濟南市第四人民醫(yī)院腫瘤科;濟南市第四人民醫(yī)院病理科;
【分類號】：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.
【作者單位】： 濟南市第四人民醫(yī)院消化內(nèi)科;濟南市第四人民醫(yī)院腫瘤科;濟南市第四人民醫(yī)院病理科;
【分類號】：R735.34
【相似文獻】
相關(guān)期刊論文 前5條
1 湯兵祥,張舒林,夏煒,劉俊剛,陳清云,孫芳,陶峰;微衛(wèi)星改變與肺癌發(fā)生發(fā)展的關(guān)系[J];河南醫(yī)學(xué)研究;2002年01期
2 王永信,柯楊;微衛(wèi)星DNA和腫瘤[J];中華腫瘤雜志;1997年06期
3 葉萍;于衛(wèi)建;王e，
本文編號：2201323
本文鏈接：http://www.wukwdryxk.cn/yixuelunwen/zlx/2201323.html
最近更新
教材專著
