摘要
目的探讨DNA错配修复（MMR）状态与结肠癌患者临床病理特征及预后的相关性。方法回顾性分析440例结肠癌根治术患者的肿瘤组织标本，采用免疫组化法检测MLH1、MSH2、MSH6和PMS2的表达情况，分析DNA错配修复缺失（dMMR）与结肠癌临床病理特征和预后的关系。结果440例结肠癌患者中，dMMR90例（20．5％），DNA错配修复完整（pMMR）350例（79．5％）。与pMMR比较，dMMR常见于年龄≤60岁、Ⅱ期、近端结肠、低分化腺癌（包括印戒细胞癌）和含黏液分泌腺癌患者，差异有统计学意义（均P〈0．05）。440例结肠癌患者中，复发转移126（28．6％），死亡93例（21．1％）。dMMR患告和pMMR患者的5年无病生存率分别为82．2％和68．9％，5年总生存率分别为85．5％和75．1％，等异均有统计学意义（均P〈0．05）。单因素和多因素分析显示，MMR状态是影响结肠癌患者无病生存时间和总生存时间的独立因1素（均P〈0．05）。结论结肠癌dMMR患者有独特的临床病理特征，更常见于年龄≤60岁、近端结肠、Ⅱ期、低分化腺癌和含黏液分泌腺癌中，是结肠癌预后较好的生物学标志物。
Objective To explore the relationship between DNA mismatch repair （MMR） and clinicupathologic featores and prognosis in patients with stages Ⅱ and Ⅲ colon cancers. Methods The clinical and pathological data of 440 patients with stage Ⅱ/Ⅲ colon cancer alter radical resection were retrospectively reviewed and analyzed, hnmunohistochenfical staining was used to assess the expression of MMR proteins （MLH1, MSH2, MSH6 and PMS2）, and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed. Results Of the 440 tumor samples tested for DNA mismatch repair status, 90 （20.5%） demonstrated defective DNA mismatch repair and 350 （79.5%） had proficient DNA mismatch repair. Detective DNA mismatch repair （dMMR） was associated witil young patients （≤60）, proximal colon cancer, stage Ⅱ, poorly differentiated adenocareinuma and mutinous adenocarcinoma （P〈0.05 for all）. Among the 440 patients, 126 （28.6%） cases had recurrence or metastasis and 93 （21.1%） died during the median follow-up of 61.0 months. The five-year disease-free survival （dFS） rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR （68.9%, P=0.02）. The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5-year disease-free survival and overall survival（OS） in colon cancer patients （P〈0.05 fur both）. Conclusions Defective DNA mismatch repair （dMMR） is associated with patients with proximal colon cancer, stage Ⅱ and poorly defferentiated adenocarcinoma and mucinous adenocarcinuma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2015年第8期591-596,共6页
Chinese Journal of Oncology
关键词
结肠肿瘤
DNA错配修复
预后
Colonic neoplasms
DNA mismatch repair
Prognosis
