目的:通过观察健脾活血方对胃癌前病变大鼠胃黏膜组织中CD44V6、MLH1及MSH2表达的影响,探讨健脾活血方对其干预的作用机制.方法:除正常组外,其他大鼠采用以N-甲基-N-硝基-N-亚硝基胍(N-methyl-N-nitro N-nitrosoguanidine,MNNG)为主同...目的:通过观察健脾活血方对胃癌前病变大鼠胃黏膜组织中CD44V6、MLH1及MSH2表达的影响,探讨健脾活血方对其干预的作用机制.方法:除正常组外,其他大鼠采用以N-甲基-N-硝基-N-亚硝基胍(N-methyl-N-nitro N-nitrosoguanidine,MNNG)为主同时配合0.3g/L雷尼替丁、400 mL/L乙醇及饥饱失常的多因素造模法建立胃癌前病变动物模型.将造模成功的40只大鼠随机分为模型组(0.9%氯化钠溶液)、胃复春组(0.86 g/kg)、健脾活血方高、中、低剂量组(32、16、8 g/kg),每组8只,每组每天给予等量(10 mL/kg)的不同药物灌胃一次,连续10 wk.实验末处死大鼠,给予相应处理后,快速免疫组织化学检测CD44V6、MLH1及MSH2表达情况.结果:模型组CD44V6表达与正常组相比明显升高(5.12±1.96 vs 0.25±0.46,P<0.01);健脾活血方高、中剂量组CD44V6表达与模型组相比均明显降低(2.25±0.71,3.25±0.31vs 5.12±1.96,P<0.01或P<0.05),低剂量组C D44V6表达与模型组比较差异无统计学意义(P>0.05);健脾活血方高剂量组CD44V6表达与胃复春组相比明显降低(2.25±0.71 vs4.62±1.19,P<0.01),中、低剂量组CD44V6表达与胃复春组比较差异无统计学意义(P>0.05).模型组MLH1、MSH2表达与正常组相比均明显降低(3.75±1.04 vs 8.00±0.926;3.62±1.69 vs 7.25±2.12,P<0.01);健脾活血方高、中、低剂量组MLH1、MSH2表达与模型组相比均明显升高(6.50±0.93,5.25±1.49,5.12±1.25 vs 3.75±1.04;6.62±2.13,6.00±1.51,5.50±1.41 vs 3.62±1.69,P<0.01或P<0.05);健脾活血方高剂量组MLH1表达与胃复春组相比明显升高(6.50±0.93 vs 4.88±1.25,P<0.05),中、低剂量组MLH1及高、中、低剂量组MSH2表达与胃复春组比较差异无统计学意义(P>0.05).结论:健脾活血方可通过降低CD44V6表达,上调MLH1、MSH2表达,减少细胞的非正常侵袭和转移,增强基因的错配修复功能,减少细胞的异常增殖和分化,发挥对大鼠胃癌前病变的治疗作用.展开更多
AIM: To analyze the prevalence of germline MLH1 and MSH2 gene mutations and evaluate the clinical characteristics of Hungarian hereditary non-polyposis colorectal cancer (HNPCC) families. METHODS: Thirty-six kindreds ...AIM: To analyze the prevalence of germline MLH1 and MSH2 gene mutations and evaluate the clinical characteristics of Hungarian hereditary non-polyposis colorectal cancer (HNPCC) families. METHODS: Thirty-six kindreds were tested for mutations using conformation sensitive gel electrophoreses, direct sequencing and also screening for genomic rearrangements applying multiplex ligation-dependent probe amplifi cation (MLPA). RESULTS: Eighteen germline mutations (50%) were identifi ed, 9 in MLH1 and 9 in MSH2. Sixteen of these sequence alterations were considered pathogenic, the remaining two were non-conservative missense alterations occurring at highly conserved functional motifs. The majority of the defi nite pathogenic mutations (81%, 13/16) were found in families fulfilling the stringent Amsterdam Ⅰ/Ⅱ criteria, including three rearrangements revealed by MLPA (two in MSH2 and one in MLH1). However, in three out of sixteen HNPCC-suspected families (19%), a disease-causing alteration could be revealed. Furthermore, nine mutations described here are novel, and none of the sequence changes were found in more than one family.CONCLUSION: Our study describes for the f irst time the prevalence and spectrum of germline mismatch repair gene mutations in Hungarian HNPCC and suspected-HNPCC families. The results presented here suggest that clinical selection criteria should be relaxed and detection of genomic rearrangements should be included in genetic screening in this population.展开更多
AIM： To assess the incidence of MLH1 （the human MutL homologue） and MSH2 （the human MutS homologue） protein expression in Turkish patients with sporadic colorectal cancers and to compare their survival and clinic...AIM： To assess the incidence of MLH1 （the human MutL homologue） and MSH2 （the human MutS homologue） protein expression in Turkish patients with sporadic colorectal cancers and to compare their survival and clinicopathological features. METHODS： We validated the tissue microarray technology in 77 colorectal carcinomas by analyzing the immunohistochemical expression of proteins involved in two main pathways of colorectal carcinogenesis： p53 protein for loss of heterozygosity tumors; MLH1 and MSH2 proteins for microsatellite instability （MSI）. RESULTS： Our analysis showed that 29 （39.2%） had loss of MLH1 expression, 5 （6.8%） had loss of MSH2 expression and 2 cases had loss of expression of both proteins. We found that 60% of MSH2-negative tumors were located in the right side of the colon; all MSH2-negative cases were women. In addition, the loss of MSH2 expression was correlated with low p53 expression. Neither MLH1 nor MSH2 expressions were associated with prognosis, although there seemed a tendency of longer survival （71.7 ± 8.65 mo vs 47.08± 5.26 too） for the patients with MLHl-negative versus MLHl-positive carcinomas. There were not significant differences in overall and recurrence-free survival among MLH1/MSH2-positive and -negative cases.CONCLUSION： Our data supports that Turkish patients with MLH1- and MSH2-defective tumors have some distinct features from each other. Although prognostic importance remains controversial, immunohistochemical analysis of mismatch repair genes may be used as a routine histopathological examination of sporadic colorectal carcinomas.展开更多
BACKGROUND The development of colorectal cancer(CRC) is a complicated multistep process that involves an accumulation of mutations in tumor suppressor genes and oncogenes.In the process of DNA replication, base mismat...BACKGROUND The development of colorectal cancer(CRC) is a complicated multistep process that involves an accumulation of mutations in tumor suppressor genes and oncogenes.In the process of DNA replication, base mismatch often occurs due to various factors leading to abnormal expression of mismatch repair genes(MMR),among which MLH1 and MSH2 are the most important.Recently, numerous studies indicated that MLH1/MSH2 phenotype is associated with CRC.We wanted to elucidate the role of MLH1/MSH2 in the prediction and prognosis of CRC through long-term clinical observation.AIM To evaluate the prognostic and predictive significance of MLH1/MSH2 in patients with stage Ⅱ-Ⅲ CRC using immunohistochemical analysis and GeneScan.METHODS Specimens from 681 patients with CRC(395 stage Ⅱ and 286 stage Ⅲ, 387 males and 294 females) who underwent curative surgical resection from 2013 to 2016 were tested.Immunohistochemistry was used to analyze MMR status and the microsatellite status of 133 patients was determined by GeneScan analysis.RESULTS Five hundred and fifty(80.76%) patients were MLH1/MSH2 positive and 131(19.24%) were negative by immunohistochemistry.MLH1/MSH2-positive tumors were significantly more frequent in the colon than in the rectum, and had poor differentiation and less mucin production(P < 0.05).Patients of different groups did not differ in terms of age, gender, tumor size, tumor stage, lymphocytic infiltration, or circumscribed margin.MLH1/MSH2-negative patients had a more favorable OS than MLH1/MSH2-positive patients(P < 0.001).Univariate and multivariate analyses demonstrated MLH1/MSH2 expression as an independent prognostic and predictive factor for stage Ⅱ/Ⅲ CRC.MLH1/MSH2 expression was a strong prognostic factor in all patients [P < 0.001, hazard ratio(HR) = 4.064,95%CI: 2.241–7.369].Adjuvant chemotherapy had a greater correlation with survival advantage in MLH1/MSH2-negative patients with stage Ⅲ disease(P <0.001, HR = 7.660, 95%CI: 2.974–15.883).However, patients with stage Ⅱ disease or MLH1/MSH2-positive patients with stage Ⅲ disease did not benefit from adjuvant chemotherapy.GeneScan analysis demonstrated that among 133 patients, 105(78.95%) were microsatellite stable, and 28(21.05%) had microsatellite instability(MSI), including 18(13.53%) with high MSI and 10(7.52%) with low MSI.This is consistent with the immunohistochemical results.CONCLUSION MLH1/MSH2 phenotype constitutes a pathologically and clinically distinct subtype of sporadic CRC.MLH1/MSH2 is an independent prognostic and predictive factor for outcome of stage Ⅱ-Ⅲ CRC.展开更多
文摘目的:通过观察健脾活血方对胃癌前病变大鼠胃黏膜组织中CD44V6、MLH1及MSH2表达的影响,探讨健脾活血方对其干预的作用机制.方法:除正常组外,其他大鼠采用以N-甲基-N-硝基-N-亚硝基胍(N-methyl-N-nitro N-nitrosoguanidine,MNNG)为主同时配合0.3g/L雷尼替丁、400 mL/L乙醇及饥饱失常的多因素造模法建立胃癌前病变动物模型.将造模成功的40只大鼠随机分为模型组(0.9%氯化钠溶液)、胃复春组(0.86 g/kg)、健脾活血方高、中、低剂量组(32、16、8 g/kg),每组8只,每组每天给予等量(10 mL/kg)的不同药物灌胃一次,连续10 wk.实验末处死大鼠,给予相应处理后,快速免疫组织化学检测CD44V6、MLH1及MSH2表达情况.结果:模型组CD44V6表达与正常组相比明显升高(5.12±1.96 vs 0.25±0.46,P<0.01);健脾活血方高、中剂量组CD44V6表达与模型组相比均明显降低(2.25±0.71,3.25±0.31vs 5.12±1.96,P<0.01或P<0.05),低剂量组C D44V6表达与模型组比较差异无统计学意义(P>0.05);健脾活血方高剂量组CD44V6表达与胃复春组相比明显降低(2.25±0.71 vs4.62±1.19,P<0.01),中、低剂量组CD44V6表达与胃复春组比较差异无统计学意义(P>0.05).模型组MLH1、MSH2表达与正常组相比均明显降低(3.75±1.04 vs 8.00±0.926;3.62±1.69 vs 7.25±2.12,P<0.01);健脾活血方高、中、低剂量组MLH1、MSH2表达与模型组相比均明显升高(6.50±0.93,5.25±1.49,5.12±1.25 vs 3.75±1.04;6.62±2.13,6.00±1.51,5.50±1.41 vs 3.62±1.69,P<0.01或P<0.05);健脾活血方高剂量组MLH1表达与胃复春组相比明显升高(6.50±0.93 vs 4.88±1.25,P<0.05),中、低剂量组MLH1及高、中、低剂量组MSH2表达与胃复春组比较差异无统计学意义(P>0.05).结论:健脾活血方可通过降低CD44V6表达,上调MLH1、MSH2表达,减少细胞的非正常侵袭和转移,增强基因的错配修复功能,减少细胞的异常增殖和分化,发挥对大鼠胃癌前病变的治疗作用.
基金Supported by the Hungarian Research Grants OTKA T-046570, NKFPI-00024/2005 and ETT 397/2006
文摘AIM: To analyze the prevalence of germline MLH1 and MSH2 gene mutations and evaluate the clinical characteristics of Hungarian hereditary non-polyposis colorectal cancer (HNPCC) families. METHODS: Thirty-six kindreds were tested for mutations using conformation sensitive gel electrophoreses, direct sequencing and also screening for genomic rearrangements applying multiplex ligation-dependent probe amplifi cation (MLPA). RESULTS: Eighteen germline mutations (50%) were identifi ed, 9 in MLH1 and 9 in MSH2. Sixteen of these sequence alterations were considered pathogenic, the remaining two were non-conservative missense alterations occurring at highly conserved functional motifs. The majority of the defi nite pathogenic mutations (81%, 13/16) were found in families fulfilling the stringent Amsterdam Ⅰ/Ⅱ criteria, including three rearrangements revealed by MLPA (two in MSH2 and one in MLH1). However, in three out of sixteen HNPCC-suspected families (19%), a disease-causing alteration could be revealed. Furthermore, nine mutations described here are novel, and none of the sequence changes were found in more than one family.CONCLUSION: Our study describes for the f irst time the prevalence and spectrum of germline mismatch repair gene mutations in Hungarian HNPCC and suspected-HNPCC families. The results presented here suggest that clinical selection criteria should be relaxed and detection of genomic rearrangements should be included in genetic screening in this population.
基金the Research Foundation of Istanbul University,No T-493/25062004
文摘AIM： To assess the incidence of MLH1 （the human MutL homologue） and MSH2 （the human MutS homologue） protein expression in Turkish patients with sporadic colorectal cancers and to compare their survival and clinicopathological features. METHODS： We validated the tissue microarray technology in 77 colorectal carcinomas by analyzing the immunohistochemical expression of proteins involved in two main pathways of colorectal carcinogenesis： p53 protein for loss of heterozygosity tumors; MLH1 and MSH2 proteins for microsatellite instability （MSI）. RESULTS： Our analysis showed that 29 （39.2%） had loss of MLH1 expression, 5 （6.8%） had loss of MSH2 expression and 2 cases had loss of expression of both proteins. We found that 60% of MSH2-negative tumors were located in the right side of the colon; all MSH2-negative cases were women. In addition, the loss of MSH2 expression was correlated with low p53 expression. Neither MLH1 nor MSH2 expressions were associated with prognosis, although there seemed a tendency of longer survival （71.7 ± 8.65 mo vs 47.08± 5.26 too） for the patients with MLHl-negative versus MLHl-positive carcinomas. There were not significant differences in overall and recurrence-free survival among MLH1/MSH2-positive and -negative cases.CONCLUSION： Our data supports that Turkish patients with MLH1- and MSH2-defective tumors have some distinct features from each other. Although prognostic importance remains controversial, immunohistochemical analysis of mismatch repair genes may be used as a routine histopathological examination of sporadic colorectal carcinomas.
基金Supported by Medical Science and Technology Development Foundation,Nanjing Department of Health,No.YKK14140(to ShuiMing Wang)and No.ZKX15040(to Bin Jiang)Project of Administration of Traditional Chinese Medicine of Jiangsu Province of China,No.LZ11101(to Zhi-Ming Fang)
文摘BACKGROUND The development of colorectal cancer(CRC) is a complicated multistep process that involves an accumulation of mutations in tumor suppressor genes and oncogenes.In the process of DNA replication, base mismatch often occurs due to various factors leading to abnormal expression of mismatch repair genes(MMR),among which MLH1 and MSH2 are the most important.Recently, numerous studies indicated that MLH1/MSH2 phenotype is associated with CRC.We wanted to elucidate the role of MLH1/MSH2 in the prediction and prognosis of CRC through long-term clinical observation.AIM To evaluate the prognostic and predictive significance of MLH1/MSH2 in patients with stage Ⅱ-Ⅲ CRC using immunohistochemical analysis and GeneScan.METHODS Specimens from 681 patients with CRC(395 stage Ⅱ and 286 stage Ⅲ, 387 males and 294 females) who underwent curative surgical resection from 2013 to 2016 were tested.Immunohistochemistry was used to analyze MMR status and the microsatellite status of 133 patients was determined by GeneScan analysis.RESULTS Five hundred and fifty(80.76%) patients were MLH1/MSH2 positive and 131(19.24%) were negative by immunohistochemistry.MLH1/MSH2-positive tumors were significantly more frequent in the colon than in the rectum, and had poor differentiation and less mucin production(P < 0.05).Patients of different groups did not differ in terms of age, gender, tumor size, tumor stage, lymphocytic infiltration, or circumscribed margin.MLH1/MSH2-negative patients had a more favorable OS than MLH1/MSH2-positive patients(P < 0.001).Univariate and multivariate analyses demonstrated MLH1/MSH2 expression as an independent prognostic and predictive factor for stage Ⅱ/Ⅲ CRC.MLH1/MSH2 expression was a strong prognostic factor in all patients [P < 0.001, hazard ratio(HR) = 4.064,95%CI: 2.241–7.369].Adjuvant chemotherapy had a greater correlation with survival advantage in MLH1/MSH2-negative patients with stage Ⅲ disease(P <0.001, HR = 7.660, 95%CI: 2.974–15.883).However, patients with stage Ⅱ disease or MLH1/MSH2-positive patients with stage Ⅲ disease did not benefit from adjuvant chemotherapy.GeneScan analysis demonstrated that among 133 patients, 105(78.95%) were microsatellite stable, and 28(21.05%) had microsatellite instability(MSI), including 18(13.53%) with high MSI and 10(7.52%) with low MSI.This is consistent with the immunohistochemical results.CONCLUSION MLH1/MSH2 phenotype constitutes a pathologically and clinically distinct subtype of sporadic CRC.MLH1/MSH2 is an independent prognostic and predictive factor for outcome of stage Ⅱ-Ⅲ CRC.
