摘要
目的分析Ⅰ~Ⅲ期左、右半结肠癌中错配修复蛋白MLH1,MSH2,MSH6和PMS2缺失表达差异和临床病理特征的关系。方法回顾性收集2018年3月—2020年12月在本院经免疫组化检测判定为错配修复缺陷(dMMR)的Ⅰ~Ⅲ期结肠癌根治术标本82例,从多项临床病理特征对比Ⅰ~Ⅲ期dMMR左、右半结肠癌错配修复蛋白表达缺失差异,以及左右半结肠癌中4种蛋白表达的相关性。结果右半结肠癌中的>60岁、隆起型、有肿瘤家族史和伴有第二原发肿瘤的dMMR人数均高于左半结肠癌组(P<0.05);中性粒细胞/淋巴细胞比值(NLR)均数高于左半结肠癌组(P<0.001);MLH1、MSH2、MSH6和PMS2在左右半结肠癌中的表达缺乏差异均无统计学意义(P>0.05)。分层分析显示右半结肠癌女性MLH1表达缺失多于左半结肠癌(P<0.05),组间分析发现MSH6缺失表达在左右半结肠癌的中、低分化组间对比和Ⅰ期、Ⅱ期之间对比差异有统计学意义(P<0.05),PMS2在右半结肠癌>60岁中表达缺失多于左半结肠癌(P<0.001)。MLH1和PMS2在82例结直肠癌中的整体表达具有正相关性,在左、右半结肠癌中的表达也分别呈正相关;MSH2和MSH6的整体表达也为正相关,在右半结肠癌中表达也呈正相关。结论左、右半结肠癌中错配修复蛋白在部分的临床病理亚组表达缺失率不同,MSH2和MSH6在左半结直肠癌中的表达无相关性,以上差异可以为临床制定个体化精准治疗方案提供进一步参考依据。
Objective To analyze the relation between difference in the expression of loss of mismatch repair proteins MLH1,MSH2,MSH6,PMS2 and clinicopathological characteristics in left-sided and right-sided colon cancer at stageⅠ~Ⅲ.Methods A retrospective study was performed on 82 patients who were diagnosed with stageⅠ~ⅢdMMR(deficient mismatch repair)colon cancer by immunohistochemical detection in The First Affiliated Hospital of Wannan Medical College from March 2018 to December 2020.This study moved on to compare the differences in the expression of loss of mismatch repair protein in left-sided and right-sided dMMR colon cancer at stageⅠ~Ⅲin terms of multiple clinicopathological features,and analyzed the correlation between the expressions of four proteins in left-sided and right-sided colon cancer.Results The number of patients with dMMR in right-sided colon cancer group who were>60 years old,uplift type,having a family history of cancer and having a second primary tumor,were higher than those in left-sided colon cancer group(P<0.05).The mean neutrophil/lymphocyte ratio(NLR)of patients with right-sided colon cancer was higher than that of patients with left-sided colon cancer(P<0.001).There was no significant difference in the expressions of MLH1,MSH2,MSH6 and PMS2 between left-sided and right-sided colon cancer(P>0.05).Stratified analysis showed that the expression of loss of MLH1 in right-sided colon cancer in women was greater than that in left-sided colon cancer(P<0.05).Inter-group analysis showed that there were significant statistical differences in the expression of MSH6 loss between the middle-and low-differentiated groups as well as between stageⅠandⅡcolon cancer(P<0.05).The expression of PMS2 loss in right-sided colon cancer patients>60 years old was higher than that of the left-sided colon cancer(P<0.001).The overall expressions of MLH1 and PMS2 were positively correlated in all the 82 cases of colorectal cancer,and also positively correlated in left-sided and right-sided colon cancer.The overall expressions of MSH2 and MSH6 were positively correlated,and the expressions of MSH2 and MSH6 were positively correlated in right-sided colon cancer.Conclusion The loss rates of mismatch repair protein expression in some clinicopathological subgroups are different in left-sided and right-sided colon cancer.And there is no correlation between the expressions of MSH2 and MSH6 in left colorectal cancer.The above differences can provide further reference for clinical development of individualized precision treatment.
作者
何杨
王俊峰
谢发琴
徐萍
张帆
朱益平
He Yang;Wang Junfeng;Xie Faqin;Xu Ping;Zhang Fan;Zhu Yiping(Department of Oncology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China;Department of Gastrointestinal Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China;Department of Pathology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)
出处
《右江民族医学院学报》
2022年第4期509-514,549,共7页
Journal of Youjiang Medical University for Nationalities
基金
安徽省自然科学基金(2108085MH290)
皖南医学院校重点项目科研基金(WK2021ZF10,WK2020ZF12)。
关键词
结肠肿瘤
错配修复蛋白
临床病理特征
colon tumor
mismatch repair protein
clinicopathological characteristics
