散发性结直肠癌患者错配修复基因蛋白表达水平及其临床意义

Mismatch Repair Gene Protein Expression and Clinical Significance in Patients with Sporadic Colorectal Carcinoma

目的检测新疆地区散发性结直肠癌患者肿瘤切除标本错配修复基因(MMR)hMLH1、hMSH2、hPSM2、hMSH6蛋白表达水平,并探讨其与患者临床病理特征之间的关系。方法选择新疆医科大学附属肿瘤医院2009年5月—2012年6月收治的散发性结直肠癌患者404例,收集其肿瘤切除标本并采用免疫组织化学染色方法检测hMLH1、hMSH2、hPSM2、hMSH6蛋白表达水平。结果 404例标本中,共110例hMLH1、hMSH2、hPSM2、hMSH6蛋白表达缺失,MMR表达缺失率为27.23%。将294例hMLH1、hMSH2、hPSM2、hMSH6蛋白表达正常患者列为A组,110例表达缺失患者列为B组。单因素分析结果显示,两组患者年龄、性别、民族、贫血发生率、肿瘤直径、肿瘤类型、TNM分期间差异均无统计学意义(P>0.05),两组患者BMI、肿瘤位置、肿瘤分化程度、肿瘤家族史间差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,BMI、肿瘤分化程度、肿瘤位置、肿瘤家族史对回归方程的影响有统计学意义(P<0.05)。结论新疆地区散发性结直肠癌患者存在MMR蛋白表达缺失,且其表达缺失与患者BMI、肿瘤位置、肿瘤分化程度、肿瘤家族史有关。

Objective To observe the protein expressions of mismatch repair（MMR,including hMLH1,hMSH2,hPSM2,and hMSH6）and to analyze their relationship to sporadic colorectal cancer（SCC） patients′ clinical pathological features.Methods The tumor samples of 404 SCC patients admitted to this hospital from May 2009 to June 2012 were collected and the protein expressions of hMLH1,hMSH2,hPSM2,and hMSH6 were determined by immunohistochemical staining methods.Results In 404 SCC specimens,110 had MMR expression deletion（27.23%）.The normal patients were enrolled into group A,the abnormal into group B.By univariated analysis,there was no significant difference in age,gender,ethnicity,anemia incidence,tumor size,tumor type,TNM staging between 2 groups（P＞0.05）,there was in BMI,tumor location,tumor differentiation degree,family history of cancer（P＜0.05）.By multivariate Logistic regression analysis,the effects of BMI,tumor differentiation degree,tumor location,family history of tumor on regression equation were significant（P＜0.05）.Conclusion The SCC patients in Xinjiang have expression deletion of MMR,which is related to BMI,tumor location,tumor differentiation degree,family history of tumor.