微卫星不稳定性与晚期结直肠癌患者姑息化疗疗效及预后的相关性

The correlation between microsatellite instability and the curative and prognosis of patients with advanced colorectal cancer palliative chemotherapy

[目的]探究微卫星不稳定性(MSI)与晚期结直肠癌(mCRC)患者姑息化疗疗效及预后的相关性。[方法]选取154例mCRC姑息化疗患者进行回顾性分析,用免疫组化方法检测肿瘤组织中错配修复基因(MMR)MLH1、MSH2,MSH6、PMS2、蛋白表达,分析MSI与临床特征、化疗反应及预后相关性。[结果]免疫组化检测结果显示:14例为dMMR/MSI⁃H,占9.09%;140例为pMMR,占90.91%。MSI⁃H组、MSS组组间患者性别、年龄、癌细胞分化程度、肿瘤转移部位、病理类型无显著差异(P>0.05),MSI⁃H组、MSS组的肿瘤部位存在明显差异(P<0.05);MSI⁃H组、MSS组总有效率无显著差异(P>0.05),MSI⁃H组疾病控制率高于MSS组(P<0.05);MSI⁃H组1 a无进展生存率85.71%(12/14);MSS组1 a无进展生存率57.86%(81/140),MSI⁃H组1 a无进展生存率高于MSS组(P<0.05)。[结论]MSI在mCRC姑息化疗患者的化疗疗效及预后影响中可能发挥着重要作用,有必要常规进行MSI⁃H检测。

[Objective]To explore the correlation between microsatellite instability MSI and the the curative and prognosis of patients with advanced colorectal cancer mCRC palliative chemotherapy.[Methods]Retrospectively selected 154 patients with advanced CRC palliative chemotherapy in our hospital from February 2017 to February 2020.Immunohistochemical methods were used to detect the protein expression of mismatch repair genes MMR MLH1 MSH2 MSH6 and PMS2 in tumor tissues and analyze MSI⁃H Correlation with clinical characteristics chemotherapy response and prognosis.[Results]The results of immunohistochemical detection showed that 14 cases were dMMR/MSI⁃H accounting for 9.09%and 140 cases were pMMR accounting for 90.91%.There was no significant difference in gender age degree of differentiation tumor metastasis and pathological types were found between MSI⁃H and MSS groups P<0.05.There was a significant difference in the lesion location between the MSI⁃H group and the MSS group P<0.05 the total effective rate of the MSI⁃H group and the MSS group was not significantly different P>0.05 and the disease control rate in the MSI⁃H group was high In the MSS group P<0.05 follow⁃up for 1 year the progression⁃free survival rate in the MSI⁃H group was 85.71%12/14 the progression⁃free survival rate in the MSS group was 57.86%81/140 and the progression⁃free survival rate in the MSI⁃H group was higher than that of MSS Group P<0.05.[Conclusion]MSI may play an important role in the chemotherapy response and prognosis of patients with advanced CRC palliative chemotherapy and it is necessary to carry out MSI testing for such patients.