上皮性卵巢癌中微卫星不稳定性的检测及临床意义

Study on microsatellite instability in epithelial ovarian cancer and its clinical significance

目的探讨微卫星不稳定性(microsatellite instability,MSI)在上皮性卵巢癌发生及发展中的作用及临床意义。方法采用PCR-聚丙烯酰胺凝胶电泳-硝酸银染色法检测63例上皮性卵巢癌组织、相应的41例盆腹腔转移灶及10例癌旁卵巢组织中MSI状态。结果上皮性卵巢癌中存在MSI,MSI-H(MSI of high frequency,高频率MSI)在上皮性卵巢癌原发灶及盆腹腔转移灶中发生率分别为22.2%及19.5%,显著高于正常卵巢组织中(P<0.05)。上皮性卵巢癌原发灶中MSI-H发生率在黏液性病理类型癌中(38.9%)显著高于浆液性病理类型癌中(8.8%)(P<0.05),在非浆液性病理类型癌中(37.9%)(黏液性、子宫内膜样及透明细胞类型)显著高于浆液性病理类型癌中(P<0.01)。结论上皮性卵巢癌中存在MSI,MSI与上皮性卵巢癌的组织学类型相关,MSI-H与非浆液性病理类型上皮性卵巢癌,尤其是黏液性上皮性卵巢癌的发生及发展密切相关。

Objective To study the role and clinical significance of microsatellite instability （MSI） in the course of tumorigenesis and progression of epithelial ovarian cancer. Methods MSI was detected by PCR-polyacrylamide gel-silver stain method in 63 epithelial ovarian cancer tissues, corresponding 41 metastatic tissues of pelvic and abdomen cavity as well as 10 adjacent non-cancerous ovarian tissues. Results MSI was detected in epithelial ovarian cancer, and the frequency of MSI-H（MSI of high frequency） was 22.2% and 19. 5% in epithelial ovarian cancer tissues and metastatic sites,respectively, which was significantly higher than that in normal ovarian tissues （P〈0. 05）. The frequency of MSI-H was significantly higher in mucinous epithelial ovarian cancer（38.9% ） than that in serous epithelial ovarian cancer （8.8 % ）（P〈0. 05）, and so was that in non-serous type epithelial ovarian cancer （37.9%） （including mucinous, endometrium and clear cell type） than that in serous type epithelial ovarian cancer （P〈0.01）. Conclusions MSI exists in epithelial ovarian cancer, which is related to histopathological type of epithelial ovarian cancer. MSI-H correlates with tumorigenesis and progression of non-serous type epithelial ovarian cancer, especially mueinous epithelial ovarian cancer.