hMLH1、hMSH2、hMSH6、Integrin β1和Ki-67在结直肠癌组织表达对预后的影响分析  

Effect of hMLH1, hMSH2, hMSH6, integrin β1, and Ki-67 expression on prognosis of colorectal cancer

作　　者：倪浩亮 韩越俊 金晰函 Hao-Liang Ni;Yue-Jun Han;Xi-Han Jin(Department of Anorectal Surgery,Jinhua Hospital of Jinhua University,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]浙江大学金华医院(金华市中心医院)肛肠外科,浙江省金华市321000

出　　处：《世界华人消化杂志》2018年第32期1857-1863,共7页World Chinese Journal of Digestology

摘　　要：目的探究分析错配修复基因(mismatch repair gene, MMR)蛋白中的h MLH1、h MSH2、h MSH6以及整合素β1(Integrinβ1)和Ki-67在结直肠癌组织表达水平以及对预后的影响.方法收集来我院治疗的结直肠癌患者的肿瘤标本162例,采用免疫组织化学染色法测定标本中hMLH1、hM SH2、hM SH6、Integrinβ1和Ki-67的表达水平,分析其影响因素,进行统计学分析比较.结果 (1)162例标本中有36例标本存在hMLH1、hMSH2、hMSH6的表达缺失,缺失率为22.22%;(2)MMR蛋白表达缺失在肿瘤直径(P=0.0005)、Dukes分期(P=0.0248)、肿瘤家族史(P=0.0042)和淋巴结转移(P=0.0014)等方面差异具有统计学意义(P<0.05);(3)Integrinβ1阳性表达水平在Dukes分期(P=0.0002)方面差异存在统计学意义(P <0.05),Ki-67的阳性表达水平在Dukes分期(P=0.0002)、淋巴结转移(P=0.0111)等方面差异具有统计学意义(P <0.05);(4)MMR蛋白表达缺失、Integrinβ1阳性表达和Ki-67的阳性表达与Dukes分期(P=0.006)、淋巴结转移(P=0.023)有关,差异具有统计学意义(P <0.05);(5)dMMR组患者5年的生存率为88.89%,pMMR组患者5年的生存率为59.52%,差异具有统计学意义(P=0.0010); Integrinβ1阳性表达组患者5年生存率为59.69%,阴性表达组患者5年生存率为90.91%,差异具有统计学意义(P=0.0007); Ki-67的阳性表达组患者5年生存率为63.27%,阴性表达组患者5年生存率为93.33%,差异具有统计学意义(P=0.0192).结论患者的MMR蛋白、Integrinβ1和Ki-67的表达水平与患者肿瘤的Dukes分期及淋巴结是否转移具有统计学意义上的相关性,且这三种因素均与患者的预后有关.其中, MMR蛋白表达缺失, Integrinβ1和Ki-67的阴性表达的患者预后情况较好,患者的5年生存率较高.AIM To investigate the expression of hMLH1,hMSH2,hMSH6,integrinβ1,and Ki-67 in colorectal cancer and to analyze their effect on the prognosis of this malignancy.METHODS One hundred and sixty-two tumor specimens of colorectal cancer patients treated in Jinhua Hospital of Jinhua University were collected,and immunohistochemical staining was used to determine the expression of hMLH1,hMSH2,hMSH6,integrinβ1,and Ki-67 in the specimens.The results were analyzed statistically.RESULTS Among 162 specimens,36 were found to have missing expression of hMLH1,hMSH2,and hMSH6,with a deletion rate of 22.22%.The expression of MMR protein was significantly associated with tumor diameter(P=0.0005),Dukes stage(P=0.0248),family history of tumor(P=0.0042),and lymph node metastasis(P=0.0014).The positive expression of integrinβ1 was significantly associated with Dukes stage(P=0.0002),and the positive expression of Ki-67 was significantly associated with Dukes stage(P=0.0002)and lymph node metastasis(P=0.0111).Loss of MMR protein expression and positive expression of integrinβ1 and Ki-67 were significantly associated with Dukes stage(P=0.006)and lymph node metastasis(P=0.023).The 5-year survival rate was 88.89%in the deficient mismatch repair group and 59.52%in the proficient mismatch repair group,and the difference was statistically significant(P=0.0010).The 5-year survival rate was significantly lower in the integrinβ1 positive group than in the integrinβ1 negative group(59.69%vs 90.91%,P=0.0007).The 5-year survival rate was also significantly lower in the Ki-67 positive group than in the Ki-67 negative group(63.27%vs 93.33%,P=0.0192).statistically correlated with Dukes stage and lymph node metastasis in colorectal cancer,and all the three factors are related to the prognosis of patients:loss of MMR protein expression and negative expression of integrinβ1 and Ki-67 are associated with better prognosis and higher 5-year survival rate.

关 键 词：错配修复基因蛋白表达 INTEGRINΒ1 KI-67 DUKES分期 淋巴结转移 

分 类 号：R735.34[医药卫生—肿瘤]