四种错配修复基因蛋白在结直肠癌中的表达及临床意义

Expression of the Four Mismatch Repair Genes Protein of Patients with Colorectal Cancer and Its Clinical Significance

目的:分析hMLH1、hMSH2、hMSH6和hPMS2四种错配修复基因蛋白在结直肠癌中的表达及其临床意义。方法:随机选取2013年1月至2015年12月广州医科大学附属第三医院结直肠癌患者标本177例,采用免疫组织化学法检测hMLH1、hMSH2、hMSH6和hPMS2蛋白的表达情况,并分析蛋白表达与临床参数间关系。结果:177例结直肠癌组织中,hMLH1蛋白的缺失率为6.2%(11/177),hMSH2蛋白的缺失率为4.0%(7/177),hMSH6蛋白的缺失率为1.7%(3/177),hPMS2蛋白的缺失率为8.0%(14/177),四者之和占所有结直肠癌病例的19.8%(35/177)。四种错配修复基因蛋白表达缺失均与肿瘤发生部位有关(P<0.05),另外,hMLH1及hPMS2蛋白的表达缺失还与肿瘤分化程度相关(P<0.05),hMSH6蛋白的表达缺失还与肿瘤浸润深度相关(P<0.05);而缺失均与年龄、性别、淋巴结转移和远处转移无关(P>0.05)。结论:错配修复蛋白的表达在部分结直肠癌组织中出现缺失现象,且与肿瘤部位及分化程度密切相关。hMLH1、hMSH2、hMSH6和hPMS2四种基因的突变,为临床判断预后及拟定治疗方案提供一个有参考价值的依据。

Objective： To analyze the expression of the four mismatch repair genes protein （hMLH1, hMSH2, hMSH6 and hPMS2） of patients with colorectal cancer and its clinical significance. Methods： 177 cases of patients with colorectal caner in the Third Affiliated Hospital of Guangzhou Medical University from January 2013 to December 2015 were randomly selected. Tested the expression of the hMLH1, hMSH2, hMSH6 and hPMS2 by immunohistochemistry, the relationship between protein expression and clinical parameters was analyzed. Results： Among 177 cases ofcolorectal cancer tissue, the deletion rate ofhMLH1 protein was 6.2% （11/177）, the deletion rate of hMLH2 protein was 4.0%（7/177）, the deletion rate of hMSH6 protein was 1.7%（3/177）, the deletion rate of hPMS2 protein was 8.0%（14/177）, the sum of the four values accounted for 19.8%（35/177） of all cases of colorectal cancer. The loss of expression of the four mismatch repair genes protein were correlated to tumor location （P〈0.05）, besides, the loss of expression of the hMLH1 and hPMS2 protein were correlated to degree of tumor differentiation （P〈0.05）, he loss of expression of the hMSH6 protein were correlated to depth of tumor invasion（P〈0.05）; But the loss was not correlated to age, sexes, lymph node metastasis and distant metastasis（P〉0.05）. Conclusion： The expression of loss phenomenon with mismatch repair protein appears in part of colorectal cancer, the loss phenomenon with mismatch repair protein were correlated to tumor location and degree of tumor differentiation. Mutations of four genes in hMLH1, hPMS2, hMSH6 and hMSH2, to provide a reference value for the clinical judgment of prognosis and to develop a treatment plan.