微卫星不稳定对散发性结直肠癌患者预后的影响  

Influence of microsatellite instability on survival of patients with sporadic colorectal cancer in China

作　　者：王小峰[1] 金黑鹰[1] 丁义江[1] 樊志敏[1] 刘秀芳[1] 耿建祥[1] 

机构地区：[1]南京中医药大学第三附属医院全国肛肠医疗中心江苏省中西医结合结直肠肿瘤诊疗中心,210001

出　　处：《中华胃肠外科杂志》2011年第7期520-523,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（30572447,30979837）;南京市医学发展重点项目（ZKX05028）;江苏省自然科学基金（BK2007009）

摘　　要：目的探讨微卫星不稳定（MSI）对散发性结直肠癌预后的影响。方法收集2004年8月至2006年9月南京中医药大学第三附属医院手术治疗并具有完整随访资料的134例结直肠癌病例．根据MSI检测结果将其分成MSI组和微卫星稳定（MSS）组。采用单因素和多因素预后分析来评估MSI的预后价值。结果134例患者中MSI组26例。MSS组108例。两组患者术后复发率分别为7．7％（2／26）和35．2％（38／108），差异有统计学意义（P=0．006）；两组患者5年生存率分别为92.3％和63．5％．差异亦有统计学意义（P=0．016）。经多因素分析，MSI为结直肠癌患者的独立预后因素（P=0．029）。结论微卫星不稳定是影响散发性结直肠癌患者预后的重要因素。Objective To investigate the role of microsatellite instability （MSI） in Chinese sporadic coloretal cancer. Methods A total of 146 patients with colorectal cancer were treated surgically from August 2004 to September 2006 in the Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. Data were collected prospectively. Univariate and muhivariable analyses were performed for parameters such as age, gender, tumor location, differentiation, MSI, tumor type, lymph node metastasis,TNM stage, and survival. Results Follow-up was available in 134 patients including telephone call and office visit. MSI（P=0.029）, tumor type（P=0.000）, TNM stage （P=0.000） were independently associated with survival on Cox regression model. There were 26 patients with MSI, and the 1-, 3-, and 5-year survival rates were 100%, 92.3%, and 92.3%, respectively. The remaining 108 patients had microsatellite stable tumor, and the 1-, 3-, and 5- year survival rates were 96.3%, 72.2%, and 63.5%, respectively. The difference was statistically significant（P=0.016）. Conclusion Microsatellite instability is an important factor associated with patient survival in Chinese sporadic colorectal cancer.

关 键 词：结直肠肿瘤 微卫星不稳定 预后 

分 类 号：R735.3[医药卫生—肿瘤]