错配修复蛋白、Ki67蛋白表达与老年结直肠癌患者根治术后无进展生存期的关系

Study on the Relationship between the Expression of Mismatch Repair Protein and Ki67 Protein and Progression Free Survival after Colorectal Cancer Resection in the Elderly

[目的]探讨错配修复蛋白、Ki67蛋白表达与老年结直肠癌(CRC)患者根治术后无进展生存期(PFS)的相关性.[方法]选取2016年10月至2021年10月在汉中市中心医院行结直肠癌根治术治疗的96例老年CRC患者,并收集患者结直肠癌组织标本和癌旁组织.比较结直肠癌组织、癌旁组织错配修复蛋白与Ki67蛋白表达情况,分析癌组织中错配修复蛋白、Ki67蛋白表达与临床病理特征的相关性,采用Cox回归分析影响老年CRC患者预后的相关因素,分析错配修复蛋白、Ki67蛋白表达与老年CRC患者根治术后PFS的相关性.[结果]结直肠癌组织错配修复蛋白阴性表达率、Ki67蛋白阳性表达率均高于癌旁组织(P<0.05).不同肿瘤直径、临床分期、淋巴结转移情况、分化程度、浸润深度的老年CRC患者癌组织中错配修复蛋白阴性表达率、Ki67蛋白阳性表达率比较,差异均有统计学意义(均P<0.05).96例老年CRC患者术后随访3年,失访3例,剩余93例患者中21例(22.58%)死亡.Cox回归分析显示,肿瘤直径、临床分期、淋巴结转移、分化程度、错配修复蛋白阴性表达、Ki67蛋白阳性表达均是影响老年CRC患者预后的独立危险因素(P<0.05).错配修复蛋白阳性表达患者与阴性表达患者生存曲线比较,差异有统计学意义(P<0.05).Ki67蛋白阴性表达患者与阳性表达患者生存曲线比较,差异有统计学意义(P<0.05).[结论]老年CRC患者癌组织错配修复蛋白阴性、Ki67蛋白阳性表达率较高,错配修复蛋白、Ki67蛋白表达与患者临床病理特征及预后均存在相关性.

【Objective】To investigate the relationship between the expression of mismatch repair protein and Ki67 protein and progression free survival(PFS)after resection of colorectal cancer(CRC)in the elderly.【Methods】From October 2016 to October 2021,96 elderly patients with CRC who underwent radical resection of colorectal cancer in Hanzhong Central Hospital were selected,and colorectal cancer tissue specimens and adjacent tissues were collected.The expression of mismatch repair protein and Ki67 protein in cancer tissues and adjacent tissues were compared.The expression of mismatch repair protein and Ki67 protein in colorectal cancer tissues and adjacent tissues were compared.The correlation between the expression of mismatch repair protein and Ki67 protein in cancer tissues and their clinicopathological characteristics was analyzed.Cox regression analysis was used to analyze the related factors affecting the prognosis of elderly CRC patients,and to analyze the correlation between the expression of mismatch repair protein and Ki67 protein and PFS in elderly CRC patients after radical surgery.【Results】The negative expression rate of mismatch repair protein and the positive expression rate of Ki67 protein in colorectal cancer tissues were higher than those in adjacent tissues(P<0.05).The negative expression rate of mismatch repair protein and the positive expression rate of Ki67 protein in the cancer tissues of elderly CRC patients with different tumor diameter,clinical stage,lymph node metastasis,degree of differentiation and depth of invasion were statistically significant(all P<0.05).Ninety six elderly patients with CRC were followed up for 3 years,3 patients were lost,and 21 of the remaining 93 patients(22.58%)died.Cox regression analysis showed that tumor diameter,clinical stage,lymph node metastasis,degree of differentiation,negative expression of mismatch repair protein and positive expression of Ki67 protein were independent factors affecting the prognosis of elderly CRC patients(P<0.05).The survival curve of patients with positive expression of mismatch repair protein was significantly different from that of patients with negative expression(P<0.05).The survival curve of patients with negative Ki67 protein expression was significantly different from that of patients with positive Ki67 protein expression(P<0.05).【Conclusion】The expression rate of mismatch repair protein(MRP)is negative and Ki67 protein is positive in elderly CRC patients.The expressions of MRP and Ki67 protein are correlated with the clinicopathological characteristics and prognosis of the patients.