微卫星不稳定、血管内皮生长因子表达情况与大肠癌患者病理特征及预后相关性分析

Correlation of microsatellite instability, vascular endothelial growth factor expression and pathological characteristics and prognosis in pa-tients with colorectal cancer

目的探讨分析微卫星不稳定(MSI)、血管内皮生长因子(VEGF)表达情况与大肠癌患者病理特征及预后相关性。方法回顾性分析本院107例行大肠癌根治术治疗的大肠癌患者临床病理资料,采用免疫组织化学方法检测107例患者手术标本肿瘤组织内MSI及VEGF表达情况,并比较MSI、VEGF表达与患者病理特征、预后相关性。结果 MSI与患者淋巴结转移与浸润深度相关(P<0.05);VEGF表达与患者血行转移、淋巴结转移、TNM分期及浸润深度相关(P<0.05);高微卫星不稳定性(MSI-H)大肠癌VEGF的表达显著减少。结论MSI与大肠癌患者淋巴结转移与浸润深度相关,而VEGF表达与大肠癌患者血行转移、淋巴结转移、TNM分期与浸润深度相关,MSI-H患者其生存及预后情况显著优于MSS及MSI-L患者;VEGF阴性患者其生存情况显著优于VEGF阳性患者。MSI-H大肠癌与微卫星稳定性(MSS)大肠癌可能存在两种不同的新生血管形成的途径,MSI-H肿瘤较低的VEGF表达或许可解释为何MSI-H大肠癌有较低的侵袭性。

Objective To investigate the correlation between microsatellite instability,vascular endothelial growth factor expression and pathological characteristics and prognosis of colorectal cancer patients. Methods In our hospital, 107 cases with colorectal cancer treated with radical surgery were retrospective studied. Clinical .and pathological data were collected, and the MSI and VEGF expression in the surgical specimens were detected by immunohistochemical method. The correlation between MSI and VEGF expression and clinic pathological features and prognosis was compared. Results The expression of MSI was correlated with lymph node metastasis and invasion depth （P〈0.05）. The expression of VEGF was correlated with hematogenous metastasis, lymph node metastasis, TNM staging and the depth of tumor invasion （P〈0.05）. The survival time of MSS pa- tients was significantly better than that of the MSI patients （P〈0.05）. The survival rate of VEGF negative patients was significantly higher than that of VEGF positive patients （P〈0.05）. Conclusion MSI and colorectal cancer patients with lymph node metastasis and invasion depth, andVEGF expression and blood metastasis in patients with colorectal cancer, lymph node metastasis, TNM staging and depth of invasion, MSI-H patient survival and prognosis was significantly better than the MSS and MSI-L patients ; VEGF-negative patients whose survival was significantly better than VEGF- positive patients. MSI-H colorectal cancer with micresatellite stable （MSS） colorectal cancer may exist in two different ways neovascularization lower MSI-H tumors VEGF expression perhaps explain why MSI-H colorectal cancer have a lower invasion sex.