老年散发性结直肠癌中hMLH1、hMSH2、hMSH6的表达及与预后的相关性  

Expression of hMLH1,hMSH2,hMSH6 in elderly patients with sporadic colorectal cancer and its correlation with prognosis

作　　者：张良良[1] 宋蒨[2] 石红建[2] 任景丽[3] 卞晓星[4] Zhang Liangliang;Song Qian;Shi Hongjian(Dept of General Surgery;Dept of Intervene in Blood Vessels,Jiangsu UniversityAffiliated Wujin Hospital,Changzhou 213002)

机构地区：[1]江苏大学附属武进医院普外科,常州213002 [2]江苏大学附属武进医院介入血管科,常州213002 [3]郑州大学第二附属医院病理科,郑州450014 [4]江苏大学附属武进医院神经外科,常州213002

出　　处：《安徽医科大学学报》2018年第9期1426-1431,共6页Acta Universitatis Medicinalis Anhui

基　　金：河南省科技攻关计划(编号:201503099)

摘　　要：目的探讨老年Ⅱ-Ⅲ期散发性结直肠癌(SCC)中错配修复蛋白(MMR)的表达及与预后的相关性。方法收集SCC术后石蜡标本232例,采用免疫组织化学法检测其中h MLH1、h MSH2、h MSH6的表达情况,分析老年SCC患者MMR表达与其临床病理特征及预后之间的关系。结果老年组、非老年组MMR蛋白表达缺失率分别为17.71%(26/152)、26.25%(21/80),差异无统计学意义(P=0.100)。对于老年散发性结直肠癌患者,MMR阴性表达在分期、分化程度、肿瘤大小、淋巴结转移间的差异均有统计学意义(P<0.05)。对于非老年SCC患者,MMR阴性表达在分期、分化程度、淋巴结转移方面差异有统计学意义(P<0.05)。对于老年SCC患者,MMR缺失组、正常组的5年生存率分别为84.62%(22/26)、56.35%(71/126),差异有统计学意义(χ2=9.001,P=0.003)。对于非老年SCC患者,MMR缺失组、正常组的5年生存率分别为80.95%(17/21)、49.15%(29/59),差异有统计学意义(χ2=6.991,P=0.008)。单因素和多因素分析显示,MMR状态是影响老年SCC患者生存时间的独立因素(P<0.05)。结论老年SCC患者MMR表达缺失多见于Ⅱ期、高分化、肿瘤直径≥5 cm的患者,更难发生淋巴结转移;MMR状态为影响老年SCC患者预后的独立因素。MMR表达缺失组较MMR正常组预后好。Objective To discuss expression of mismatch repair（ MMR） protein in elderly patients with stages Ⅱ-Ⅲ sporadic colorectal cancer（ SCC） and its correlation with prognosis. Methods 232 cases of SCC paraffin specim after surgery were enrolled in this study. Immunohistochemistry was used to detect expression of h MLH1,h MSH2 and h MSH6. The relationship between expression of MMR protein and its clinic pathological features and prognosis in elderly SCC was analyzed. Results The missing rate of MMR protein expression was 17. 71%（ 26/152） in elderly patients with SCC. The missing rate of MMR protein expression was 26. 25%（ 21/80） in non-elderly patients with SCC. There was no significant difference between the two groups（ P = 0. 100）. For elderly patients with SCC,the deletion of MMR were significantly different in stage,differentiation degree,tumor diameter,lymph node metastasisand（ P〈0. 05）. For non-elderly patients with SCC,the deletion of MMR were significantly different in stage,differentiation degree,lymph node metastasisand（ P〈0. 05）. For elderly patients with SCC,the five-year survival rate was 84. 62%（ 22/26） in the deficient MMR group and 56. 35%（ 71/126） in the proficient MMR group,the difference was statistically significant（ χ~2= 9. 001,P = 0. 003）. For non-elderly patients with SCC,the five-year survival rate was 80. 95%（ 17/21） in the deficient MMR group and 49. 15%（ 29/59） in the proficient MMR group,the difference was statistically significant（ χ~2= 6. 991,P = 0. 008）. The univariate and multivariate analysis showed that MMR status was an independent factor influencing survival time in patients with elderly patients with SCC. Conclusion MMR deletion in elderly patients with SCC is more common in patients with stage II tumors,well differentiated tumors and tumor diameter≥5 cm. The deficient MMR group is more difficult to occur lymph node metastasis. MMR status is an independent factor affecting the prognosis of elderly patients with SCC.The p

关 键 词：错配修复蛋白 结直肠癌 老年 病理特征 预后 

分 类 号：R574.6[医药卫生—消化系统]