MSI、HGF与大肠癌患者预后关系的初步研究

Influences of microsatellite instability and hepatocyte growth factor on prognosis of patients with colorectal cancer

目的探讨微卫星不稳定性(MSI)和肝细胞生长因子(HGF)对大肠癌患者预后的影响。方法选取2011年4月-2014年7月四川省巴中市中医医院收治的大肠癌患者80例,记录MSI患者和HGF阳性患者的生存率,对患者的临床资料进行单因素和COX回归分析。结果 MSI患者14例,1、3和5年生存率分别为92.86%、85.71%和71.43%;非MSI患者14例,1、3和5年生存率分别为92.42%、74.24%和56.06%。HGF阳性患者14例,1、3和5年生存率分别为89.47%、73.68%和54.39%;HGF阴性患者14例,1、3和5年生存率分别为100.00%、82.61%和73.91%。不同大体类型、TNM分期、分化程度、是否淋巴结转移、辅助化疗、MSI、HGF阳性和阴性患者的5年生存率比较,差异有统计学意义(P<0.05)。TNM分期Ⅲ、Ⅳ,以及淋巴结转移、HGF阳性是影响大肠癌患者生存状况的独立危险因素,辅助化疗和MSI是患者生存的保护因素(P<0.05)。结论 MSI、HGF与大肠癌患者预后密切相关,其中MSI患者比非MSI患者预后佳,而HGF阳性患者预后较阴性患者差。

Objective To investigate the effect of microsatellite instability(MSI)and hepatocyte growth factor(HGF)on the prognosis of patients with colorectal cancer.Methods Eighty patients with colorectal cancer in our hospital from April2011to July2014were selected.The survival rates of the patients with MSI and the HGFpositive patients were recorded.The clinical data of the patients were analyzed with univariate and COX regression analyses.Results In the14cases of MSI patients,1-,3-and5-year survival rates were92.86%,85.71%and71.43%respectively;in the66cases of the non-MSI patients,1-,3-,5-year survival rates were92.42%,74.24%and56.06%respectively.In the57cases of HGF-positive patients,1-,3-and5-year survival rates were89.47%,73.68%and54.39%respectively;while in the23cases of HGF-negative patients,1-,3-and5-year survival rates were100.00%,82.61%and73.91%respectively.There were significant differences in the5-year survival rates of the patients with different pathological types,TNM stages,differentiation degree,lymph node metastasis,adjuvant chemotherapy,MSI and HGF expressions(P<0.05).TNM stage III and IV,lymph node metastasis and HGF positivity were the independent risk factors influencing the survival status of the colorectal cancer patients.Adjuvant chemotherapy and MSI were the protective factors for the survival of the patients(P<0.05).Conclusions MSI and HGF are the main factors influencing the prognosis of the patients with colorectal cancer.MSI patients have a better prognosis than non-MSI patients,whereas HGF-positive patients have a worse prognosis than HGF-negative patients.