Canary Institute for Cancer Research, Las Palmas de Gran Canaria, Canary Islands, Spain.
Int J Radiat Oncol Biol Phys. 2010 Jan 1;76(1):9-13. doi: 10.1016/j.ijrobp.2009.09.035.
To elucidate whether microsatellite instability (MSI) predicts clinical outcome in radiation-treated endometrioid endometrial cancer (EEC).
A consecutive series of 93 patients with EEC treated with extrafascial hysterectomy and postoperative radiotherapy was studied. The median clinical follow-up of patients was 138 months, with a maximum of 232 months. Five quasimonomorphic mononucleotide markers (BAT-25, BAT-26, NR21, NR24, and NR27) were used for MSI classification.
Twenty-five patients (22%) were classified as MSI. Both in the whole series and in early stages (I and II), univariate analysis showed a significant association between MSI and poorer 10-year local disease-free survival, disease-free survival, and cancer-specific survival. In multivariate analysis, MSI was excluded from the final regression model in the whole series, but in early stages MSI provided additional significant predictive information independent of traditional prognostic and predictive factors (age, stage, grade, and vascular invasion) for disease-free survival (hazard ratio [HR] 3.25, 95% confidence interval [CI] 1.01-10.49; p = 0.048) and cancer-specific survival (HR 4.20, 95% CI 1.23-14.35; p = 0.022) and was marginally significant for local disease-free survival (HR 3.54, 95% CI 0.93-13.46; p = 0.064).
These results suggest that MSI may predict radiotherapy response in early-stage EEC.
阐明微卫星不稳定性（MSI）是否能预测接受放疗的子宫内膜样型子宫内膜癌（EEC）的临床结局。
对 93 例接受筋膜外子宫切除术和术后放疗的 EEC 患者进行了连续系列研究。患者的中位临床随访时间为 138 个月，最长随访时间为 232 个月。使用 5 个准单核苷酸标记物（BAT-25、BAT-26、NR21、NR24 和 NR27）进行 MSI 分类。
25 例患者（22%）被归类为 MSI。在整个系列和早期（I 期和 II 期）中，单因素分析显示 MSI 与 10 年局部无病生存率、无病生存率和癌症特异性生存率较差显著相关。多因素分析显示，MSI 在整个系列中被排除在最终回归模型之外，但在早期阶段，MSI 提供了独立于传统预后和预测因素（年龄、分期、分级和血管侵犯）的局部无病生存（危险比 [HR] 3.25，95%置信区间 [CI] 1.01-10.49；p=0.048）、癌症特异性生存（HR 4.20，95%CI 1.23-14.35；p=0.022）的显著预测信息，局部无病生存也有边缘显著（HR 3.54，95%CI 0.93-13.46；p=0.064）。
这些结果表明，MSI 可能预测早期 EEC 对放疗的反应。
