摘要
目的 探讨DNA错配修复（MMR）与Ⅱ～Ⅲ期结肠癌预后和术后接受氟尿嘧啶单药辅助治疗疗效的相关性.方法 收集172例结肠癌根治术患者的肿瘤组织标本,采用免疫组化法检测MLH1、MSH2、MSH6和PMS2蛋白的表达情况,比较MMR缺失（dMMR）和MMR完整（pMMR）患者的生存情况.结果 172例结肠癌患者中,dMMR 38例（22.1％）,pMMR 134例（77.9％）.115例单纯手术患者中,dMMR患者的5年无病生存率和5年总生存率分别为84.0％和88.0％,pMMR患者的5年无病生存率和5年总生存率分别为60.0％和66.7％ （P =0.034,P=0.040）.38例dMMR患者中,单纯手术组的5年无病生存率（84.0％）明显高于术后氟尿嘧啶单药辅助治疗组（53.8％,P=0.038）.134例pMMR患者中,术后氟尿嘧啶单药辅助治疗组的5年总生存率（86.4％）明显优于单纯手术组患者（66.7％,P=0.012）.结论 MMR状态与结肠癌预后有关,dMMR是结肠癌预后较好的生物指标.MMR状态与能否从术后氟尿嘧啶治疗中获益有关,pMMR患者能从术后氟尿嘧啶辅助治疗中获益,而dMMR患者不能从术后氟尿嘧啶辅助治疗中获益。
Objective To investigate the role of DNA mismatch repair （MMR） as a prognostic indicator of radical resection and a predictor of fluorouracil-based adjuvant therapy benefit in patients with stage Ⅱ/Ⅲ colon cancer.Methods The clinicopathological characteristics of 172 patients with stage Ⅱ/Ⅲ colon cancer who underwent radical resection were retrospectively analyzed.Immunohistochemical staining was used to detect the expression of DNA mismatch repair （MLH1/MSH2/MSH6/PMS2） in the tumor tissues.Results Among a total of 172 patients,there were 38 （22.1%） cases with defective DNA mismatch repair （dMMR） and 134 （77.9%） cases with proficient DNA mismatch repair （pMMR）.Among the 115 patients who did not receive adjuvant chemotherapy,those with tumor displaying dMMR had a better 5-year overall survival （OS） rate and disease-free survival （DFS） rate than the patients with proficient DNA mismatch repair （pMMR） （88.0% vs.66.7%,P =0.040 ; 84.0% vs.60.0%,P =0.034）.The benefit of adjuvant chemotherapy differed significantly according to the MMR status.Adjuvant 5-Fu chemotherapy improved the 5-year overall survival rate among 134 patients with pMMR （86.4%） than that in patients treated by surgery alone （66.7%,P =0.012）.By contrast,there was no benefit of adjuvant 5-Fu chemotherapy in the patients with dMMR （61.5% vs.86.4%,P =0.062）,which was even more clear the 5-year disease-free survival rate （53.8% vs.84.0%,P =0.038）.Conclusions MMR status is a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage Ⅱ/Ⅲ colon cancer.Patients with stage Ⅱ/Ⅲ colon cancer displaying dMMR have a better prognosis than those with pMMR.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2014年第11期844-848,共5页
Chinese Journal of Oncology
关键词
结肠肿瘤
DNA错配修复
治疗
预后
预测
Colonic neoplasms
DNA mismatch repair
Therapy
Prognosis
Forecasting
