卵巢子宫内膜样癌中错配修复蛋白的表达与临床特征及微卫星不稳定表型的关系  

Analysis of Clinical Characteristics of Endometrioid Ovarian Cancer Regarding MMR Protein Expression and Its Association with MSI Phenotype

作　　者：肖雪[1] 董丹丹[1] 宋林红[1] XIAO Xue;DONG DANDan;SONG Linhong(Sichuan Academy of Medical Sciences ＆ Sichuan Provincial People＇s HospitaI,Chengdu Sichuan 610072,China)

机构地区：[1]四川省医学科学院四川省人民医院,四川成都610072

出　　处：《实用妇产科杂志》2018年第8期605-608,共4页Journal of Practical Obstetrics and Gynecology

基　　金：四川省科技计划资助(编号:2018JY0157)

摘　　要：目的:初探错配修复(MMR)蛋白在卵巢子宫内膜样癌(EOC)中的表达情况,MMR蛋白异常与EOC的临床特征及微卫星不稳定(MSI)表型的关系。方法:收集2008年1月至2015年12月在我院接受手术治疗的EOC患者的存档石蜡样本共73例。用免疫组织化学染色法(IHC)检测MMR蛋白的表达情况,并用MSI实验检测癌组织丰富的样本和对应的远癌正常组织样本的MSI表型。结果:73例中有10例(13.7%)EOC肿瘤有MMR异常,包括肿瘤MMR完全缺失6例(8.2%)和肿瘤MMR低表达5例(5.5%)。MMR蛋白异常与患者年龄、FIGO分期、肿瘤分化等因素无关。60%的MMR异常组术前CA125小于140 U/ml,65.1%的MMR正常组术前CA125值大于140 U/ml,两组差异有统计学意义(P<0.05),MMR异常组无进展生存期(PFS)长于MMR正常组,两组差异有统计学意义(P<0.05)。73例中有15例满足MSI实验测试要求进行了测试,5例(100%)MMR异常患者均表现为MSI,其中4例MMR完全缺失表现为高度微卫星不稳定(MSI-H),1例MMR低表达表现为低度微卫星不稳定(MSI-L);10例(100%)MMR正常病例均表现为微卫星稳定(MSS)。结论:在EOC中MMR异常与MSI表型可能有关;MMR异常患者的术前CA125水平可能低于MMR正常患者,预后可能比MMR正常患者更好。Objective： To investigate the incidence of MMR protein deficiency（ MMRd） in endometrioid ovarian cancer（ EOC）,and understand the clinical association of MMRd and the concordance between MMRd andmicrosatellite instability（ MSI）. Methods： We collected 73 samples of EOC diagnosed from January 2008 to December2015 in our hospital.MMR status was detected by IHC tests.MSI assay was used to determine MSI of tumor samples and their corresponding normal tissue samples.Results： 13. 7%（ 10/73 cases） of EOC had MMR defects,including 6 cases（ 8. 2%） tumors with complete MMR deficiency and 5 cases（ 5. 5%） tumors with reduced MMR protein expression.MMRd were not related on age,stage and tumor differentiation. 60% of MMRd patients＇ preoperative CA125 value was lower than 140 U/ml,while 65. 1% MMR proficient patients＇ preoperative CA125 value was over 140 U/ml,there was significant difference in preoperative CA125 between MMR deficient patients and MMR proficient patients（ P〈0. 05）.In addition,compared with MMR proficient patients,patients with MMRd had significantly longer progression free survival（ P〈0. 05）.MSI tests were conducted in 15 cases out of the 73 cases which met the requirement of MSI assay.MSI was found in all 5 cases（ 100%） MMRd cases including 4 MSI-H cases which had complete MMR deficiency in their tumors;and 1 MSI-L case which had low MMR expression in its tumor.MSS was seen in all 10 cases MMR proficient tumors tested for MSI.Conclusions： MMRd may correlate with MSI phenotype in EOC,and MMRd may associate with lower preoperative CA125 level and better prognosis.

关 键 词：卵巢子宫内摸样癌 错配修复蛋白 微卫星不稳定 

分 类 号：R737.31[医药卫生—肿瘤]