214例胃癌微卫星不稳定状态分析  

Analysis of microsatellite instability status in 214 cases of gastric carcinomas

作　　者：缪小兵[1] 吴雅珣 蔡南南 宗桂娟[1] 陈旭东[1] 尹海兵[1] 陈亚丽[1] 何松[1] MIAO Xiao-bing;WU Ya-xun;CAI Nan-nan;ZONG Gui-juan;CHEN Xu-dong;YIN Hai-bing;CHEN Ya-li;HE Song(Department of Pathology,Nantong Cancer Hospital,Nantong 226361,China)

机构地区：[1]江苏省南通市肿瘤医院病理科,南通226361

出　　处：《临床与实验病理学杂志》2018年第11期1208-1212,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：南通市科技项目(HS2015003)

摘　　要：目的分析胃癌组织微卫星不稳定(microsatellite instability,MSI)状态及其临床病理意义。方法利用PCR法检测MONO-27、BAT-25、NR-21、BAT-26以及NR-24位点,分析214例胃癌组织的MSI状态;同时利用免疫组化法检测MLH1、MSH2、MSH6以及PMS2错配修复蛋白的表达。结果 PCR法检测发现214例胃癌中微卫星稳定(microsatellite stable,MSS)占69. 2%(148/214),低度微卫星不稳定(microsatellite stable-low,MSI-L)占20. 1%(43/214),高度微卫星不稳定(microsatellite stable-high,MSI-H)占10. 7%(23/214)。MSI-H与肿瘤部位(P=0. 022)、肿瘤直径(P=0. 001)以及肿瘤淋巴细胞浸润(P<0. 001)相关,与患者性别、年龄、Lauren分型、浸润深度、淋巴结转移、TNM分期、脉管侵犯以及神经侵犯均无关(P均>0. 05)。免疫组化检测发现,214例胃癌中,192例(89. 7%)中MLH1、MSH2、MSH6以及PMS2错配修复蛋白表达均无缺失; 6例(2. 8%)仅一种错配修复蛋白表达缺失; 16例(7. 5%)两种及以上错配修复蛋白同时缺失。使用PCR法与免疫组化法检测MSI状态结果一致者155例(72. 4%),结果不一致者59例(27. 6%)。结论 MSI-H在直径较大以及胃中部的肿瘤中多见,且肿瘤浸润淋巴细胞的数目明显多于MSS型及MSI-L型胃癌。Purpose To evaluate microsatellite instability( MSI) status in gastric carcinomas and its relationship with clinicopathological characteristics. Methods The MSI test was performed using a PCR-based assay by amplifying MONO-27,BAT-25,NR-21,BAT-26 and NR-24 in 214 gastric carcinoma tissues. Meanwhile,expression of the four mismatch repair proteins MLH1,MSH2,MSH6,and PMS2 was studied by immunohistochemistry. Results A PCR-based assay revealed that69. 2%( 148/214) of patients had microsatellite stable( MSS)tumors,20. 1%( 43/214) had MSI-low( MSI-L) tumors and10. 7%( 23/214) had MSI-high( MSI-H) tumors. MSI-H was significantly correlated with tumor location( P = 0. 022),tumor diameter( P = 0. 001) and tumor lymphocytic infiltration( P <0. 001). However,MSI-H was not correlated with gender,age,Lauren type,infiltration depth,lymph node metastasis,TNM stage,vascular invasion and nerve invasion( all P > 0. 05). Among 214 gastric carcinomas,192( 89. 7%) patients had normal expression of the four mismatch repair proteins MLH1,MSH2,MSH6,and PMS2. Six( 2. 8%) patients showed isolated loss of expression of the four mismatch repair proteins. Sixteen( 7. 5%) patients showed simultaneous loss of 2 or more expression of the four mismatch repair proteins. Furthermore,we found that 115 of the 214( 72. 4%) cases had consistent PCR and immunohistochemical results, whereas 59 of the 214( 27. 6%) cases had inconsistent results. Conclusion The MSI-H tumors are more common in larger tumors and middle one-third gastric carcinomas. Moreover,the MSI-H tumors show increased tumor-infiltrating lymphocytes when compared with MSS and MSI-L tumors.

关 键 词：胃肿瘤 微卫星不稳定 临床病理特征 

分 类 号：R735.2[医药卫生—肿瘤]