散发性结直肠癌微卫星不稳定状态与临床病理特征及预后的关系
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摘要
选取213例散发性结直肠癌(CRC)患者的手术切除标本,采用免疫组化(IHC)方法检测肿瘤组织中错配修复蛋白(MMR)表达及PCR-毛细管电泳法检测微卫星状态。213例患者中微卫星不稳定(MSI)为35例,占16%,MSI与肿瘤组织学分级、分型、部位、淋巴结转移、分期有关,随机抽取20例标本进行PCR-毛细管电泳法检测,其中3例肿瘤组织显示高频微卫星不稳定(MSI-H)。MSI肿瘤具有明显的临床病理特征,预后优于微卫星稳定(MSS)患者。
213 cases of sporadic colorectal cancer were selected. The expression of mismatch repair protein( MMR) was detected by immunohistochemistry,and the microsatellite status was detected by PCR-capillary electrophoresis. Microsatellite instability( MSI) was found in 35 out of 213 cases,accounting for 16%. MSI was related to histological grade,classification,location,lymph node metastasis and staging of tumor. 20 cases were randomly selected for PCR-capillary electrophoresis,and 3 cases showed high frequency microsatellite instability( MSI-H). MSI tumors have obvious clinicopathologic features and have better prognosis than MSS patients.
213 cases of sporadic colorectal cancer were selected. The expression of mismatch repair protein( MMR) was detected by immunohistochemistry,and the microsatellite status was detected by PCR-capillary electrophoresis. Microsatellite instability( MSI) was found in 35 out of 213 cases,accounting for 16%. MSI was related to histological grade,classification,location,lymph node metastasis and staging of tumor. 20 cases were randomly selected for PCR-capillary electrophoresis,and 3 cases showed high frequency microsatellite instability( MSI-H). MSI tumors have obvious clinicopathologic features and have better prognosis than MSS patients.
引文
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[11]Popat S,Hubner R,Houlston R S,et al.Systematic review of microsatellite instability and colorectal cancer prognosis[J].J Clin Oncol,2005,23(3):609-18.
[2]秦云,梁莉萍,郑兴征等,免疫组织化学法检测结直肠癌四种DNA错配修复蛋白表达缺失对判断肿瘤微卫星状态的价值.[J]中华病理学,2015,44(10):704-8.
[3]Siegel R,Desantis C,Jemal A.Colorectal cancer statistics[J].CA Cancer Clin,2014,64(2):104-17.
[4]Thibodeau S N,Bren G,Schaid D.Microsatellite instability in cancer of the proximal colon[J].Science,1993,260(5109):816-9.
[5]Zoratto F,Rossi L,Verrico M,et al.Focus on genetic and epigenetic events of colorectal cancer pathogenesis:implications for molecular diagnosis[J].Tumour Biol,2014,35(7):6195-206.
[6]Raut C P,Pawlik T M,Rodriguez-Bigas M A.Clinicopathologic features in colorectal cancer patients with microsatellite instability[J].Mutat Res,2004,568(2):275-82.
[7]Boland C R.Clinical uses of microsatellite instability testing in colorectal cancer:an ongoing challenge[J].J Clin Oncol,2007,25(7):754-6.
[8]Ghanipour L,Jirstrom K,Sundstrom M,et al.Associations of defect mismatch repair genes with prognosis and heredity in sporadic colorectal cancer[J].Eur J Surg Oncol,2017,43(2):311-21.
[9]Karahan B,Argon A,Yιdιrιm M,et al.Relationship between MLH-1,MSH-2,PMS-2,MSH-6 expression and clinicopathological features in colorectal cancer[J].Int J Clin Exp Pathol,2015,8(4):4044-53.
[10]Andre’T,de Gramont A de,Vernerey D,et al.Adjuvant fluorouracil,leucovorin,and oxaliplatin in stageⅡtoⅢcolon cancer:updated 10-year survival and outcomes according to BRAF mutation and mismatch repair status of the MOSAIC study[J].J Clin Oncol,2015,33(35):4176-87.
[11]Popat S,Hubner R,Houlston R S,et al.Systematic review of microsatellite instability and colorectal cancer prognosis[J].J Clin Oncol,2005,23(3):609-18.