摘要
目的分析青海地区汉、藏、回族结直肠癌4种错配修复蛋白(MMR)(MLH1、MSH6、MSH2、PMS2)的表达情况,探讨与结直肠癌临床病理特征和生存预后之间的关系。方法收集我院2016年1月至2019年6月手术切除的312例结直肠癌标本(其中汉族164例、藏族83例、回族65例),取手术切除的结直肠癌组织标本,采用免疫组化法检测MMR表达情况。用PBS代替一抗作为阴性对照,用正常的结直肠癌黏膜上皮作为阳性对照。结果312例结直肠癌标本中错配修复蛋白表达缺失(dMMR)56例,表达缺失率17.9%;其中仅MLH1蛋白表达缺失12例(3.8%),仅MSH2蛋白表达缺失25例(8.0%),仅MSH6蛋白表达缺失8例(2.6%),仅PMS2蛋白表达缺失11例(3.5%),MLH1和PMS2蛋白表达均缺失19例(6.1%),MSH2和MSH6蛋白表达均缺失18例(5.8%)。MMR蛋白表达情况与结直肠癌临床病理特征之间的关系分析发现,MMR蛋白表达缺失与年龄、性别、浸润深度、民族无关,与pTNM分期、发病部位、淋巴结转移情况、病理组织学有关(P<0.05);错配修复蛋白表达完整(pMMR)、dMMR患者的中位无病生存期(DFS)分别是13.3个月和22.7个月,经Log-rank检验dMMR患者的DFS明显长于pMMR的患者(χ^(2)=98.587,P<0.001)。结论青海地区结直肠癌患者dMMR在不同民族之间表达无显著差异,肿瘤发病部位、pTNM分期、病理组织学、淋巴结转移情况影响结直肠癌中MMR的表达,dMMR的结直肠癌患者DFS更长。
Objective To analyze the expression of four kinds of mismatch repair protein(MMR)(MLH1,PMS2,MSH6,MSH2)in colorectal cancer of Han,Tibetan and Hui nationality in Qinghai province,and explore the relationship between clinicopathological features and survival prognosis.Methods From January 2016 to June 2019,312 cases of colorectal cancer were collected in Qinghai people's Hospital,including 164 cases of Han,83 cases of Tibetans and 65 cases of Hui.Colorectal cancer tissue specimens were taken from surgical resection.MMR expressions were detected by immunohistochemical method.PBS was used as negative control,and normal colorectal mucosal epithelium was used as positive control.Results The ficiency expression of MMR(dMMR)was found in 56/312 cases(17.9%).Among them,only MLH1 protein expression was absent in 12/312 cases(3.8%),only MSH2 protein expression was absent in 25/312 cases(8.0%),only MSH6 protein expression was absent in 8/312 cases(2.6%),only PMS2 protein expression was absent in 11/312 cases(3.5%),MLH1 and PMS2 protein expression were absent in 19/312 cases(6.1%),and MSH2 and MSH6 protein expression were absent in 18/312 cases(5.8%).Relationship analysis between MMR and clinicopathological features of colorectal cancer showed that the loss of MMR protein expression was not related to age,gender,nationality and depth of invasion,while it was related to pTNM stage,location,lymph node metastasis and histopathology(P<0.05).The median disease-free survival time(DFS)of mismatch repair protein expression deletion(dMMR)and mismatch repair protein expression intact(pMMR)was 22.7 months and 13.3 months,respectively.Log-rank test showed that DFS of dMMR patients was significantly longer than that of pMMR patients(χ^(2)=98.587,P<0.001).Conclusion There is no significant difference in dMMR expression of colorectal cancer patients in Qinghai among different ethnic groups.Tumor site,pTNM stage,histopathology and lymph node metastasis could affect MMR expression in colorectal cancer patients,and DFS in colorectal cancer pat
作者
袁青玲
王冬梅
杨娟
赞梅
宋晓燕
肖成华
张梦岚
本巴吉
Yuan Qingling;Wang Dongmei;Yang Juan(Qinghai Provincial People′s Hospital,Xining,Qinghai 810007,China)
出处
《四川医学》
CAS
2021年第7期693-697,共5页
Sichuan Medical Journal
关键词
结直肠癌
错配修复蛋白
临床病理特征
免疫组织化
mismatch repair protein
colorectal cancer
immunohistochemistry
clinicopathological features
