摘要
目的探讨DNA错配修复蛋白(MMR)缺失与Ⅱ、Ⅲ期结肠癌根治术后复发转移及预后的关系。方法采用免疫组织化学法检测294例结肠癌患者手术标本的MMR表达,回顾性分析其表达对结肠癌患者临床病理参数及生存率的影响。结果多因素分析结果显示,肿瘤部位、分化程度和分期是影响MMR表达状态的独立性危险因素(P<0.05);单因素结果显示,年龄、分化程度、T和N分期是影响患者复发转移率、总体生存率的危险因素;仅有N分期是影响患者复发转移率的独立性危险因素;仅有肿瘤分化程度、N分期和MMR缺失是影响患者总体生存率的独立性危险因素。220例DNA错配修复缺陷蛋白完整(pMMR)患者中,69例出现复发转移(31.4%),48例死亡(21.8%);74例DNA错配修复蛋白缺失(dMMR)患者中,13例出现复发转移(17.6%),9例死亡(12.2%)。两组患者的无病生存率(P=0.034)、总体生存率(P=0.047)差异均具有统计学意义。结论肿瘤部位、分化程度和分期与MMR表达状态密切相关;MMR表达缺失患者预后明显较差,可作为判断患者预后的一个潜在标志物。
Objective To explore the relationship between the loss of DNA mismatch repair protein(MMR)and the recurrence,metastasis and prognosis of stageⅡandⅢcolon cancer after radical operation.Methods Immunohistochemistry was used to detect the expression of MMR in 294 patients with colorectal cancer.The influence of MMR expression on clinicopathological parameters and survival rate of patients with colorectal cancer was analyzed retrospectively.Results Multivariate analysis showed that tumor location,differentiation and stage were independent risk factors for MMR expression(P<0.05).The single factor results showed that age,differentiation degree,stage T and N were the risk factors of recurrence and metastasis rate and overall survival rate;only stage N was the independent risk factors of recurrence and metastasis rate;only tumor differentiation degree,stage N and MMR deficiency were the independent risk factors of overall survival rate.Among 220 patients with pMMR,69 had relapse and metastasis(31.4%)and 48 died(21.8%);among 74 patients with dMMR,13 had relapse and metastasis(17.6%)and 9 died(12.2%).The difference of disease-free survival rate(P=0.034)and overall survival rate(P=0.047)between the two groups were statistically significant.Conclusion The location,degree of differentiation and stage of tumor are closely related to the expression of MMR.The prognosis of patients with MMR expression deficiency is obviously poor,which can be used as a potential marker to judge the prognosis of patients.
作者
覃军
王耀明
郑广才
马鑫
QIN Jun;WANG Yaoming;ZHENG Guangcai;MA Xin(Department of General Surgery,Yulin Red Cross Hospital,Yulin Guangxi 537000,China;Department of Outpatient,986 Air Force Hospital,Xi′an 710054,China)
出处
《新疆医科大学学报》
CAS
2020年第5期607-610,614,共5页
Journal of Xinjiang Medical University
基金
陕西省医学研发计划项目(2017SX-0392)。
关键词
DNA错配修复蛋白
结肠癌
无病生存率
总体生存率
DNA mismatch repair protein
colon cancer
disease-free survival
overall survival rate
作者简介
覃军(1967-),男,本科,副主任医师,研究方向:普外科临床疾病治疗;通信作者:马鑫,男,主治医师,研究方向:普外科临床疾病治疗,E-mail:fanruoluuwl@163.com。
