结直肠癌组织中错配修复蛋白缺失的临床意义

Clinical significance of mismatch repair deficiency in colorectal cancer tissue

目的分析错配修复蛋白缺失(dMMR)与结直肠癌临床病理特征的关系,探讨dMMR对结直肠癌诊治的临床意义。方法收集2021年12月—2023年7月济宁市第一人民医院胃肠外科经手术治疗的212例结直肠癌患者的相关临床病理资料,对dMMR与患者性别、年龄、肿瘤分化程度、TNM分期、T分期、N分期、有无脉管癌栓、有无神经侵犯、肿瘤部位及组织学类型等的相关性进行分析。结果212例结直肠癌患者中有12例dMMR(5.66%),其中32例右半结肠癌患者中有4例dMMR(12.50%);60例左半结肠癌患者中有6例dMMR(10.00%),120例直肠癌患者中有2例d MMR(1.67%),检出率差异有统计学意义(P<0.05)。dMMR与结直肠癌患者的性别、年龄、肿瘤分化程度、TNM分期、T分期、N分期、有无脉管癌栓及有无神经侵犯无关,仅与肿瘤部位、组织学类型有关。dMMR在右半结肠癌组织中和黏液腺癌组织中检出率更高。结论dMMR在不同类型结直肠癌患者中检出率差异有统计学意义,该指标检测有助于为患者提供个性化的精准诊疗方案并判断预后。

Objective To analyze the relationship between mismatch repair deficiency(dMMR)and clinical pathological characteristics of colorectal cancer,and explore the clinical significance of dMMR in diagnosis and treatment of colorectal cancer.Methods The clinical and pathological data of 212 patients with colon and rectal cancer undergoing surgical treatment in gastroenterology department of Jining First People's Hospital from December 2021 to July 2023 were collected,and the correlation of dMMR and gender,age,degree of differentiation,TNM stage,T stage,N stage,presence of vascular cancer thrombus,presence of nerve invasion,tumor location and histological type were analyzed.Results Among 212 patients,there were 12 cases(5.66%)with dMMR.Among the 32 patients with right colon cancer,there were 4 cases(12.50%)with dMMR.Among 60 patients with left colon cancer,only 6 cases(10.00%)had dMMR,while among 120 patients with rectal cancer,2 cases(1.67%)had dMMR.The differences were statistically significant(P<0.05).dMMR was not associated with gender,age,degree of differentiation,TNM stage,T stage,N stage,presence of vascular cancer thrombus or presence of nerve invasion in colorectal cancer patients,but related to tumor location and histological type.The incidence of dMMR was higher in right colon cancer tissue and mucinous adenocarcinoma tissue.Conclusion The difference in incidence of dMMR among colorectal cancer patients is statistically significant,and dMMR detection could help make personalized and accurate diagnosis and treatment plans for patients and determine prognosis.