结直肠癌432例微卫星状态及病理特征对预后的影响分析

Analysis of the effect of microsatellite status and pathological features on prognosis in 432 cases of colorectal cance

目的研究结直肠癌病人的微卫星状态及病理特征对其治疗及预后的影响因素。方法选取于2015年1月至2021年5月安徽省第二人民医院收治的符合条件的432例结直肠癌病人,其中微卫星高度不稳定性(MSI-H)组病人27例,微卫星低度不稳定性(MSI-L)/微卫星稳定(MSS)组405例,并在基本特征与病理特征方面做对比研究。结果两组在家族史对比中,MSI-H组(33.3%)与MSI-L/MSS组(11.4%)两组比较差异有统计学意义(P<0.05);而MSI-H组病人肿瘤发生部分多见于右半结肠(63.0%),而MSI-L/MSS组多见于直肠(57.0%),在两组病理学形态对比下MSI-H组浸润性占33.3%,明显高于MSI-L/MSS组的4.7%;在TNM分期上,MSI-H组的Ⅰ期+Ⅱ期肿瘤占比44.4%,明显高于MSI-L/MSS组的24.6%;在是否有癌结节方面对比,MSI-H组有癌结节占比33.3%,高于MSI-L/MSS组的11.6%(P<0.05);结论MSI-H的结直肠癌病人在相关病理特征下与MSI-L/MSS组有明显差异,MSI-H组病人家族遗传可能性更大,肿瘤TNM分期上MSI-H分期更早,这对结直肠癌预后及治疗提供有力的证据。

Objective To study the influencing factors of microsatellite status and pathological features of colorectal cancer patients on their treatment and prognosis.Methods Four hundred and thirty-two eligible colorectal cancer patients admitted to the Second People's Hospital of Anhui Province from January 2015 to May 2021 were enrolled,including 27 patients in the microsatellite high instability(MSI-H)group and microsatellite low instability(MSI-L)group/microsatellite stabilization(MSS)group of 405 cases,and the basic and pathological characteristics were compared and studied.Results In the comparison of family history between the two groups,the difference between the MSI-H group(33.3%)and the MSI-L/MSS group(11.4%)was statistically significant(P<0.05),while the MSI-H group was part of the tumor,and it was more common in the right colon(63.0%),while the MSI-L/MSS group was more common in the rectum(57.0%).In the comparison of pathological morphology between the two groups,the infiltration of MSI-H group accounted for 33.3%,which was significantly higher than that of 4.7% of the MSI-L/MSS group;in the TNM staging,the proportion of stage Ⅰ+stage Ⅱ tumors in the MSI-H group accounted for 44.4%,which was significantly higher than 24.6%in the MSI-L/MSS group.In terms of whether there was cancer nodules,the proportion of cancerous nodules in the MSI-H group was 33.3%,which was higher than 11.6% in the MSI-L/MSS group.The difference between the two groups was statistically significant(P<0.05).Conclusion MSI-H colorectal cancer patients are significantly different from the MSI-L/MSS group under the relevant pathological characteristics,and the familial genetic possibility of patients in MSI-H group is greater,and the MSI-H staging is earlier in the TNM staging of tumors,which provides strong evidence for the prognosis and treatment of colorectal cancer.