结直肠癌(CRC)中错配修复蛋白MLH1、MSH2、PMS2、MSH6及P53的表达及其临床意义

The Expression and Clinical significance of Mismatch Repair Proteins MLH1,MSH2,PMS2,MSH6 and P53 in Colorectal Cancer(CRC)

目的通过检测结直肠癌患者标本中5种不同错配修复蛋白因子的表达水平,探讨其临床意义。方法随机抽出2019年12月—2021年5月61例结直肠癌(CRC)病例作研究,经实验室病理检测MLH1、MSH2、PMS2、MSH6及P53的表达差异,并采用统计学软件完成相关性分析。结果4种错配修复蛋白缺失患者占比约18.03%(11/61),单种蛋白表达缺失占比最低为4.92%,最高为11.48%,MLH1、PMS2共同表达缺失为8.20%明显高于MSH2、MSH6共同表达缺失3.28%;P53蛋白表达阳性率47.54%(29/61)。4种错配修复蛋白表达所致微卫星不稳定与组织分型、TNM分期有关(χ^(2)=8.614、4.104,P=0.003、0.043),P53蛋白阳性表达与组织分型、TNM分期、淋巴结转移有关(χ^(2)=6.050、4.102、7.110,P=0.014、0.043、0.008);且P53蛋白表达阳性与微卫星不稳定呈现负性相关(r=-0.136,P<0.05)。结论CRC患者MLH1、PMS2蛋白缺失占比远高于MSH2、MSH6蛋白缺失,P53蛋白阳性表达与组织分型、分期、淋巴结转移有关;MLH1、MSH2、PMS2、MSH6及P53的表达与CRC发病和病情进展有一定关联。

Objective To investigate the clinical significance of five different mismatch repair protein factors in colorectal cancer specimens.Methods 61 cases of colorectal cancer(CRC)from December 2019 to May 2021 were randomly selected for research.The expression differences of MLH1,MSH2,PMS2,MSH6 and P53 were detected by laboratory pathology,and the correlation analysis was completed by statistical software.Results The patients with missing 4 mismatch repair proteins accounted for about 18.03%(11/61).The lowest percentage of single protein expression loss was 4.92%,and the highest was 11.48%.The co-expression loss of MLH1 and PMS2 was 8.20%,which was significantly higher than that of MSH2 and MSH6 co-expression loss of 3.28%.The positive rate of P53 protein expression was 47.54%(29/61).The instability of microsatellites caused by the expression of 4 mismatch repair proteins was related to tissue typing and TNM staging(χ^(2)=8.614,4.104,P=0.003,0.043).The positive expression of P53 protein was related to tissue typing,TNM staging,and lymph node metastasis(χ^(2)=6.050,4.102,7.110,P=0.014,0.043,0.008).And the positive expression of P53 protein was negatively correlated with microsatellite instability(r=-0.136,P<0.05).Conclusion The proportion of MLH1 and PMS2 protein missing in CRC patients is much higher than that of MSH2 and MSH6 protein missing.The positive expression of P53 protein is related to tissue typing,staging,and lymph node metastasis.The expression of MLH1,MSH2,PMS2,MSH6 and P53 is related to the incidence and progression of CRC.