Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2011 Mar;26(3):585-92. doi: 10.1111/j.1440-1746.2010.06487.x.
A subset of gastric cancers showed high microsatellite instability (MSI-H). The reported clinicopathological features of MSI-H gastric cancers are heterogeneous, and specific factors associated with prognosis have not been identified.
We analyzed the clinicopathological characteristics and prognostic factors in a large series (161 cases) of MSI-H gastric cancers, and compared the results to 315 cases of microsatellite-stable or low microsatellite-instable gastric cancers.
The frequency of MSI-H gastric cancers was 9% (161/1786). MSI-H gastric cancers have distinct clinicopathological features, including female sex, older age, antral location, well-to-moderate differentiation, intestinal-type Lauren classification, expanding-type Ming classification, a non-signet-ring cell component, the presence of a mucinous component, a moderate-to-severe lymphoid stromal reaction, and a lower tumor stage. The MSI-H phenotype was associated with better prognosis (P = 0.044), and male sex (P = 0.035, hazard ratios [HR]: 0.23), intestinal-/mixed-type Lauren classification (P < 0.001, HR: 0.09) and lower tumor stages (1 and 2, P = 0.001, HR: 0.08) were independently-favorable prognostic factors.
With unique clinicopathological features, intestinal-type MSI-H gastric cancers are associated with good prognosis and can be classified as a different subset of gastric cancers.
部分胃癌表现出高度微卫星不稳定（MSI-H）。MSI-H 型胃癌的报道临床病理特征具有异质性，尚未确定与预后相关的具体因素。
我们分析了大量 MSI-H 型胃癌（161 例）的临床病理特征和预后因素，并将结果与 315 例微卫星稳定或低微卫星不稳定型胃癌进行比较。
MSI-H 型胃癌的频率为 9%（161/1786）。MSI-H 型胃癌具有独特的临床病理特征，包括女性、年龄较大、胃窦部、中-高分化、肠型 Lauren 分类、扩展型 Ming 分类、非印戒细胞成分、存在黏液成分、中-重度淋巴间质反应和较低的肿瘤分期。MSI-H 表型与较好的预后相关（P = 0.044），男性（P = 0.035，风险比[HR]：0.23）、肠型/混合型 Lauren 分类（P < 0.001，HR：0.09）和较低的肿瘤分期（1 期和 2 期，P = 0.001，HR：0.08）是独立的预后良好因素。
具有独特临床病理特征的肠型 MSI-H 型胃癌与良好的预后相关，可归类为胃癌的不同亚群。
