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散发性结肠癌的 DNA 错配修复和辅助化疗。

DNA mismatch repair and adjuvant chemotherapy in sporadic colon cancer.

机构信息

Division of Oncology, Mayo Clinic and Mayo Cancer Center, Rochester, MN 55905, USA.

出版信息

Nat Rev Clin Oncol. 2010 Mar;7(3):174-7. doi: 10.1038/nrclinonc.2009.235.

DOI:10.1038/nrclinonc.2009.235
PMID:20190798
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3767984/
Abstract

Defective DNA mismatch repair (MMR) occurs in approximately 15% of sporadic colorectal cancers (CRCs). Multiple retrospective studies have shown that patients with MMR-deficient CRCs have a more favorable stage-adjusted prognosis compared with those who have MMR-proficient tumors. Evidence also indicates that patients with MMR-deficient colon cancers do not benefit from treatment with adjuvant 5-fluorouracil chemotherapy. Furthermore, recent studies, including a pooled analysis, have validated the prognostic and predictive impact of MMR status in patients with stage II and III colon cancer who were treated in adjuvant chemotherapy trials. Given these data, it can be recommended that MMR status be determined and used to inform clinical decision-making for adjuvant chemotherapy in patients with stage II colon cancer.

摘要

错配修复(MMR)缺陷发生于约 15%的散发性结直肠癌(CRC)中。多项回顾性研究表明,与 MMR 功能正常的肿瘤相比,MMR 缺陷型 CRC 患者的调整后分期预后更好。有证据还表明,MMR 缺陷型结肠癌患者不能从辅助 5-氟尿嘧啶化疗中获益。此外,最近的研究,包括一项汇总分析,已经验证了 MMR 状态在辅助化疗试验中治疗的 II 期和 III 期结肠癌患者中的预后和预测影响。鉴于这些数据,可以建议确定 MMR 状态,并用于告知 II 期结肠癌患者辅助化疗的临床决策。

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本文引用的文献

1
Model-based prediction of defective DNA mismatch repair using clinicopathological variables in sporadic colon cancer patients.基于模型的散发性结肠癌患者临床病理变量的缺陷性 DNA 错配修复预测。
Cancer. 2010 Apr 1;116(7):1691-8. doi: 10.1002/cncr.24913.
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Microsatellite instability predicts improved response to adjuvant therapy with irinotecan, fluorouracil, and leucovorin in stage III colon cancer: Cancer and Leukemia Group B Protocol 89803.微卫星不稳定性预示着III期结肠癌患者对伊立替康、氟尿嘧啶和亚叶酸钙辅助治疗的反应改善:癌症与白血病B组研究方案89803。
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Molecular characterization of MSI-H colorectal cancer by MLHI promoter methylation, immunohistochemistry, and mismatch repair germline mutation screening.通过MLHI启动子甲基化、免疫组织化学和错配修复种系突变筛查对微卫星高度不稳定(MSI-H)结直肠癌进行分子特征分析。
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The efficacy of adjuvant chemotherapy with 5-fluorouracil in colorectal cancer depends on the mismatch repair status.5-氟尿嘧啶辅助化疗在结直肠癌中的疗效取决于错配修复状态。
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Cost analysis of biomarker testing for mismatch repair deficiency in node-positive colorectal cancer.淋巴结阳性结直肠癌错配修复缺陷生物标志物检测的成本分析
Br J Surg. 2008 Jul;95(7):868-75. doi: 10.1002/bjs.6172.
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Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study.贝伐单抗联合奥沙利铂为基础的化疗作为转移性结直肠癌的一线治疗:一项随机III期研究。
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Irinotecan fluorouracil plus leucovorin is not superior to fluorouracil plus leucovorin alone as adjuvant treatment for stage III colon cancer: results of CALGB 89803.伊立替康联合氟尿嘧啶及亚叶酸钙作为Ⅲ期结肠癌辅助治疗并不优于单独使用氟尿嘧啶及亚叶酸钙:癌症和白血病B组89803研究结果
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Prognostic and predictive roles of high-degree microsatellite instability in colon cancer: a National Cancer Institute-National Surgical Adjuvant Breast and Bowel Project Collaborative Study.高度微卫星不稳定性在结肠癌中的预后和预测作用:一项美国国立癌症研究所-美国国立外科辅助乳腺和肠道项目协作研究
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Microsatellite instability did not predict individual survival of unselected patients with colorectal cancer.微卫星不稳定性无法预测未经选择的结直肠癌患者的个体生存率。
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