微卫星不稳定与结直肠癌临床病理特征及预后的关系

THE RELATIONSHIP BETWEEN MICROSATELLITE INSTABILITY AND THE CLINICOPATHOLOGIC FEATURES AND PROGNOSIS OF COLORECTAL CANCER

目的探讨结直肠癌微卫星不稳定性及其与结直肠癌临床病理特征和患者预后的关系。方法应用免疫组织化学方法检测60例结直肠癌组织中错配修复蛋白表达情况,判断肿瘤微卫星不稳定(Microsatellite instability,MSI)状态,并分析高度微卫星不稳定(Microsatellite instabilityhigh,MSI-H)和低度微卫星不稳定(Microsatellite instability-low,MSI-L)/微卫星稳定(Microsatellite stable,MSS)不同组别间的临床病理特征及生存预后情况。结果 60例结直肠癌患者的肿瘤组织中MSI-H为40%(24/60),MSI-L及MSS为60%(36/60),MSI-H的结直肠癌患者,肿瘤好发于右半结肠(P=0.014)、粘液腺癌多见(P=0.022)。两组在性别、年龄、分期、肿瘤浸润深度、淋巴结转移、分化程度方面无明显差异(P>0.05)。MSI-H患者的无病生存期(Disease-free survival,DFS)明显长于MSS及MSI-L患者(P=0.042)。结论 MSI-H与MSI-L及MSS相比,MSI-H的结直肠癌患者具有独特的临床病理特征且预后相对较好。

Objective To explore the relationship between microsatellite instability and the clinicopathologic features and prognosis of colorectal cancer.Methods Immunohistochemistry was used to detect the mismatch repair protein expressions in the tumor tissues from 60 cases.The tumor microsatellite instability（MSI）were judged.The clinicopathologic features and prognosis of colorectal cancer in patients of microsatellite instability-high（MSI-H）and microsatellite instability-low（MSI-L）or microsatellite stable（MSS）status.Results The MSI-H,and MSI-L or MSS cases in the tumor tissues from 60 patients accounted for 60%and 40%respectively.In the MSI-H cases,the tumors usually occurred in the right hemicolon（P =0.014）with frequent mucinous adenocarcinoma（P =0.022）.There was no significant difference in gender,age,clinical stage,depth of tumor invasion,lymph node metastasis and differentiation degree between the two groups（P 〉0.05）.The disease-free survival（DFS）of MSI-H cases was significantly longer than that of MSI-L or MSS cases（P =0.042）.Conclusion Compared with MSI-L and MSS cases,the MSI-H colorectal cancer patients have unique clinicopathologic features and good prognosis.