微卫星不稳定、Her-2在结直肠癌中的表达及临床意义  

The Expression of Microsatellite Instability and Her-2 in Colorectal Cancer and Clinical Significance

作　　者：权秋颖 郭凌川[1] 黄山[1] 何晓顺 陈志[1] 郭霞 曹磊 QUAN Qiu-ying;GUO Ling-chuan;HUANG Shan;HE Xiao-shun;CHEN Zhi;GUO Xia;CAO Lei(Department of Pathology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China;Jiangsu Institute of Clinical Immunology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院病理科,江苏苏州215006 [2]苏州大学附属第一医院临床免疫学研究所,江苏苏州215006

出　　处：《中国血液流变学杂志》2021年第4期435-439,499,F0002,共7页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(81874163)。

摘　　要：目的探讨微卫星不稳定(microsatellite instability,MSI)与Her-2在结直肠癌(colorectal cancer,CRC)中的表达与病人临床病理特征的关系,以及联合检测MSI和Her-2在临床治疗中的意义。方法收集苏州大学附属第一医院2019年1月1日-12月31日的CRC患者493例,采用免疫组织化学方法观察错配修复蛋白MLH1、PMS2、MSH2、MSH6和Her-2的蛋白表达情况,采用卡方检验或Fisher确切概率法分析各组之间的相关性。结果493例CRC患者中,微卫星高度不稳定(microsatellite instability-High,MSI-H)共43例,为8.7%(43/493);微卫星低度不稳定(microsatellite instability-Low,MSI-L)及微卫星稳定(microsatellite stable,MSS)共450例,为91.3%(450/493)。MSI-H的CRC患者,肿瘤体积较大(P=0.001),分化低(P<0.001),好发于右半结肠(P<0.001),黏液腺癌多见(P<0.001),两组(MSI-H与MSI-L/MSS)在其他指标方面差异无统计学意义(P>0.05)。Her-2的过表达病例共13例,为2.6%(13/493),其表达与肿瘤分化程度(P<0.05)、发生部位(P<0.05)相关,与微卫星状态存在相关性(P<0.05)。结论MSI-H的CRC患者与MSI-L/MSS相比具有独特的临床病理特点,MSI与Her-2的表达呈正相关,联合检测MSI与Her-2在CRC中的表达对评估肿瘤风险及选择治疗策略具有一定参考价值。Objective To investigate the protein expression of microsatellite instability(MSI)and Her-2 in colorectal cancer(CRC)as well as the correlation with patients clinical and pathological characteristics and significance.Methods For 493 patients from January to December 2019 in the First Affiliated Hospital of Soochow University,the immunohistochemical method was applied to detect the protein expressions of MLH1,PMS2,MSH2,MSH6 and Her-2,and the correlation between the groups was analyzed by chi-square test or Fisher's exact probability test.Results Among the 493 cases,patients with microsatellite instability high(MSI-H)accounted for 8.7%(43/493).And patients with microsatellite instability low(MSI-L)and microsatellite stable(MSS)accounted for 91.3%(450/493).Patients with MSI-H showed large tumor volume(P=0.001),low differentiation(P<0.001),more likely to occur in right colon(P<0.001)and mucinous adenocarcinoma(P<0.001).There was no significant difference in other factors between the two groups(MSI-H and MSI-L/MSS)(P>0.05).The expression of Her-2 was correlated with tumor differentiation and location(P<0.05),as well as with microsatellite status(P<0.05).Conclusion MSI-H patients have unique clinicopathological characteristics compared with MSI-L/MSS groups.There was a positive correlation between the expression of MSI and Her-2,and combined detection of MSI and Her-2 expression has vital reference value for assessing tumor risk and selecting treatment strategies.

关 键 词：结直肠癌 微卫星不稳定 HER-2 免疫组化 

分 类 号：R735.3[医药卫生—肿瘤] R446.8[医药卫生—临床医学]