免疫组化法检测结直肠癌错配修复基因蛋白结果分析
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摘要
目的分析错配修复基因(MMR)蛋白采用免疫组化法的检测结果,探讨其与结直肠癌的关系。方法用免疫组化法(IHC)对4种MMR蛋白进行检测,MLH1、PMS2、MSH2、MSH6均表达者为错配修复完整(p MMR),有一种以上及以上错配修复基因蛋白表达缺失为错配修复缺陷(dMMR)。结果 96例结直肠癌标本中,pMMR者85例(88.5%),dMMR者11例(11.5%);MMR蛋白缺失与CRC在发病部位和淋巴结转移方面有差异(P<0.05),在患者性别、发病年龄、肿瘤大小方面差异不明显(P>0.05)。结论结直肠癌的发病机制部分与MMR缺陷有关,且dMMR者好发于右半结肠,较少有淋巴结转移的病理特征。
Objective To detect the expression of mismatch repair proteins in colorectal cancer,and to analyze the correlation between MMR and pathologic features of colorectal cancer. Methods Immunohistochemistry(IHC)was used to detect four MMR proteins. All expression was classified as the MMR proficient(pMMR).Absent expression of one or more of these proteins was classified as the MMR deficient(dMMR). Results Among the 96 cases of colorectal cancer,85 cases were pMMR(88.5%)and 11 cases were dMMR(11.5%). Patients with MMR deficient CRC had difference in tumor location and lymph node metastasis(P<0.05). There was no obvious difference in gender,age,and tumor size(P>0.05). Conclusion The pathogenesis of colorectal cancer is related to MMR deficient,and dMMR is more common in the right semicolon,with less lymph node metastasis.
Objective To detect the expression of mismatch repair proteins in colorectal cancer,and to analyze the correlation between MMR and pathologic features of colorectal cancer. Methods Immunohistochemistry(IHC)was used to detect four MMR proteins. All expression was classified as the MMR proficient(pMMR).Absent expression of one or more of these proteins was classified as the MMR deficient(dMMR). Results Among the 96 cases of colorectal cancer,85 cases were pMMR(88.5%)and 11 cases were dMMR(11.5%). Patients with MMR deficient CRC had difference in tumor location and lymph node metastasis(P<0.05). There was no obvious difference in gender,age,and tumor size(P>0.05). Conclusion The pathogenesis of colorectal cancer is related to MMR deficient,and dMMR is more common in the right semicolon,with less lymph node metastasis.
引文
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[2] SHIA J,ELLIS N A,PATY P B,et al. Value of histopathology in predicting microsatellite instability in hereditary nonpolyposis colorectal cancer and sporadic colorectal cancer[J]. Am J Surg Pathol,2003,27(11):1407-1417.
[3] JUNG S B,LEE H I,OH H K,et al. Clinicopathologic parameters for prediction of microsatellite instability in colorectal cancer[J]. Cancer Res Treat,2012,44(3):179-186.
[4]刘晓红,曹永成,王翠翠,等.Lynch综合征相关直肠癌患者的初步筛查[J].中华病理学杂志,2014,(43):394-398.
[5] NATIONAL COMPREHENSIVE CANCER NETWORK. NCCN Clinical Practice Guidelines in Oncology:colon cancer(version2. 2 017)[EB/OL].[2017-10-13]. https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.
[6] PALOMAKI G E,MCCLAIN M R,MELILLO S,et al. EGAPP supplementary evidence review:DNA testing strategies aimed at reducing morbidity and mortality from Lynch syndrome[J]. Genet Med,2009,11(1):42-65.
[7] KAWAKAMI H,ZAANAN A,SINICROPE F A. Microsatellite instability testing and its role in the management of colorectal cancer[J].Curr Treat Options Oncol,2015,16(7):30.
[8] STEINKE V,ENGEL C,BUTTNER R,et al. Hereditary nonpolyposis colorectal cancer(HNPCC)/Lynch syndrome[J]. Dtsch Arztebl Int,2013,110(3):32-38.
[9] LOCHHEAD P,KUCHIBA A,IMAMURA Y,et al. Microsatellite instability and BRAF mutation testing in colorectal cancer prognostication[J]. J Natl Cancer Inst,2013,105(15):1151-1156.
[10] MOHAN H M,RYAN E,BALASUBRAMANIAN I,et al. Microsatellite instability is associated with reduced disease specific survival in stage III colon cancer[J]. Eur J Surg Oncol,2016,42(11):1680-1686.