Barrasa Shaw Antonio, López-Guerrero José Antonio, Calatrava Fons Ana, García-Casado Zaida, Alapont Olavarrieta Vicente, Campos Máñez Jorge, Vázquez Albaladejo Carlos
General Surgery Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
Clin Transl Oncol. 2009 Jul;11(7):465-9. doi: 10.1007/s12094-009-0386-y.
Recent studies defend a possible prognostic and therapeutic value of the identification of microsatellite instability (MSI) in colorectal cancer. This work tries to assess the impact that the identification of MSI tumours can have in clinical practice.
We recovered tumour samples from 92 of the 143 patients operated on for colorectal cancer in our institution between 1995 and 2000. Five MSI markers (BAT 25, BAT 26, D2S123, D5S346 and D17S250) were studied on them. The rate and clinicopathologic characteristics of MSI tumours were investigated along with their impact on the global and disease-free survival as compared with microsatellite stable (MSS) tumours.
All 5 microsatellite markers' status were established in 73 patients (79.3% of the samples). Among them, 7 tumours showed instability in just one marker (low microsatellite instability [MSI-L]) whereas 5 tumours had mutations in 2 or more markers (high microsatellite instability [MSI-H]), for a total 15.4% rate of MSI tumours. All MSI-H tumours were located in the right colon. We could not fi nd any impact from MSI detection on global or disease-free survival.
MSI determination did not identify groups of patients with a different prognosis. Moreover, with such low incidence its determination can only be justified in those cases that fulfill Bethesda's criteria to identify families with Lynch's syndrome.
近期研究支持结直肠癌中微卫星不稳定性（MSI）的识别可能具有预后和治疗价值。本研究旨在评估MSI肿瘤的识别对临床实践的影响。
我们从1995年至2000年间在我院接受结直肠癌手术的143例患者中选取了92例，获取其肿瘤样本。对这些样本研究了5个MSI标记物（BAT 25、BAT 26、D2S123、D5S346和D17S250）。研究了MSI肿瘤的发生率、临床病理特征，以及与微卫星稳定（MSS）肿瘤相比，其对总生存和无病生存的影响。
73例患者（占样本的79.3%）确定了所有5个微卫星标记物的状态。其中，7例肿瘤仅在一个标记物中显示不稳定性（低微卫星不稳定性[MSI-L]），而5例肿瘤在2个或更多标记物中有突变（高危卫星不稳定性[MSI-H]），MSI肿瘤的总发生率为15.4%。所有MSI-H肿瘤均位于右半结肠。我们未发现MSI检测对总生存或无病生存有任何影响。
MSI检测未能识别出预后不同的患者群体。此外，由于其发生率较低，仅在符合贝塞斯达标准以识别林奇综合征家族的病例中进行MSI检测才具有合理性。
