结直肠癌Lynch综合征的病理学特征与微卫星不稳定性的相关性研究  

Correlation between microsatellite instability and pathological features of Lynch syndrome in colorectal cancer

作　　者：刘琴 梦琳 刘丹丹 LIU Qin;Meng Lin;LIU DanDan(Department of Pathology,Central Hospital of Xinyu Iron and Steel Group Co.,Ltd,Xinyu,Jiangxi,338001,China)

机构地区：[1]新余钢铁集团有限公司中心医院病理科,江西新余338001

出　　处：《当代医学》2022年第32期28-30,共3页Contemporary Medicine

基　　金：江西省新余市科技计划项目(20203090880)。

摘　　要：目的探讨结直肠癌Lynch综合征的病理学特征与微卫星不稳定性(MSI)的相关性。方法选取2019年6月至2021年5月本院收治的80例直肠癌Lynch综合征患者作为研究对象,采用免疫组织化学检测MMR蛋白(MLH1、MSH2、MSH6、PMS2)表达情况,判断其微卫星状态,分为微卫星稳定(MSS)、低度微卫星不稳定(MSI-L)、高度微卫星不稳定(MSI-H),分析MSI与其临床病理特征的相关性。结果80例直肠癌Lynch综合征患者中检查出MSS 55例,占比68.75%;MSI-H 22例,占比27.50%;MSI-L 3例,占比3.75%;MSI发生率为31.25%。MSI-H与非MSI-H性别、年龄、TNM分期比较差异无统计学意义;MSI-H与非MSI-H肿瘤直径≥5 cm、肿瘤在右半部位、黏液及低分化中占比比较差异有统计学意义(P<0.05)。结论结直肠癌Lynch综合征MSI常发生于肿块较大、右半结肠,并以低分化的黏液腺癌为主,检测MSI状态对加强结直肠癌Lynch综合征的诊治,对延长患者生存期有积极意义。Objective To investigate the correlation between the pathological features of Lynch syndrome in colorectal cancer and microsatellite instability(MSI).Methods A total of 80 patients with Lynch syndrome with rectal cancer admitted to our hospital from June 2019 to May 2021 were selected as research subjects,and the expression of MMR proteins(MLH1,MSH2,MSH6,PMS2)was detected by immunohistochemistry,and the microsatellite status was judged,which were divided into microsatellite stability(MSS),low microsatellite instability(MSI-L),and high microsatellite instability(MSI-H),and the correlation between MSI and its clinicopathological features was analyzed.Results Among 80 patients with Lynch syndrome with rectal cancer,55 cases of MSS were detected,accounting for 68.75%.MSI-H 22 cases,accounting for 27.50%;MSI-L 3 cases,accounting for 3.75%;the incidence of MSI was 31.25%.There were no significant differences between gender,age,and TNM stage between MSI-H and non-MSI-H.There were significant differences between MSI-H and non-MSI-H tumors with a diameter of≥5 cm,and the proportion of tumors in the right hemisphere,mucus and poorly differentiated(P<0.05).Conclusion MSI of colorectal cancer Lynch syndrome often occurs in the right colon with large masses,and is mainly poorly differentiated mucinous adenocarcinoma,and the detection of MSI status is of positive significance to strengthen the diagnosis and treatment of colorectal cancer Lynch syndrome and prolong the survival of patients.

关 键 词：结直肠癌 LYNCH综合征 微卫星状态 错配修复蛋白 临床病理特征 

分 类 号：R735.3[医药卫生—肿瘤]