高频微卫星不稳定性在内膜样腺癌中具有预后价值，但仅在 FIGO 分期 1 病例中。
High frequency microsatellite instability has a prognostic value in endometrial endometrioid adenocarcinoma, but only in FIGO stage 1 cases.
机构信息
Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
出版信息
Anal Cell Pathol (Amst). 2010;33(5):245-55. doi: 10.3233/ACP-CLO-2010-0550.
OBJECTIVES
to analyze the prognostic value of microsatellite instability (MSI) in a population-based study of FIGO stage 1-4 endometrial endometrioid adenocarcinomas.
STUDY DESIGN
survival analysis in 273 patients of MSI status and clinico-pathologic features. Using a highly sensitive pentaplex polymerase chain reaction to establish MSI status, cases were divided into microsatellite stable (MSS), MSI-low (MSI-L, 1 marker positive) and MSI-high (MSI-H, 2-5 markers positive).
RESULTS
after 61 months median follow-up (1-209), 34 (12.5%) of the patients developed metastases but only 6.4% of the FIGO 1. MSI (especially as MSI-H vs. MSS/MSI-Lcombined) was prognostic in FIGO 1 but not in FIGO 2-4. The 5 and 10 year recurrence-free survival rates were 98% and 95% in the MSS/MSI-L vs. 85% and 73% in the MSI-H patients (p=0.005).
CONCLUSIONS
MSI-H status assessed by pentaplex polymerase chain reaction is an indicator of poor prognosis in FIGO 1, but not in FIGO 2-4 endometrial endometrioid adenocarcinomas.
目的
在基于人群的 FIGO 分期 1-4 期子宫内膜样腺癌中分析微卫星不稳定性（MSI）的预后价值。
研究设计
对 273 例 MSI 状态和临床病理特征患者进行生存分析。采用高度敏感的五重聚合酶链反应确定 MSI 状态，将病例分为微卫星稳定（MSS）、MSI-低（MSI-L，1 个标志物阳性）和 MSI-高（MSI-H，2-5 个标志物阳性）。
结果
中位随访 61 个月（1-209 个月）后，34 例（12.5%）患者发生转移，但仅 FIGO 1 中 6.4%的患者存在 MSI（尤其是 MSI-H 与 MSS/MSI-L 联合）。MSI（尤其是 MSI-H 与 MSS/MSI-L 联合）在 FIGO 1 中具有预后意义，但在 FIGO 2-4 中无此意义。MSS/MSI-L 组的 5 年和 10 年无复发生存率分别为 98%和 95%，MSI-H 组分别为 85%和 73%（p=0.005）。
结论
五重聚合酶链反应评估的 MSI-H 状态是 FIGO 1 期子宫内膜样腺癌不良预后的指标，但不是 FIGO 2-4 期的指标。
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