MSI-H 型结肠癌的临床病理特征和预后分析。
Clinicopathologic features and prognostic analysis of MSI-high colon cancer.
机构信息
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, 11217, Taipei, Taiwan, Republic of China.
出版信息
Int J Colorectal Dis. 2012 Mar;27(3):277-86. doi: 10.1007/s00384-011-1341-2. Epub 2011 Nov 12.
PURPOSE
The objectives of the study were to estimate the incidence and clarify the clinicopathologic feature of sporadic microsatellite instability (MSI)-high (MSI-H) colon cancer. Furthermore, the role of MSI in colon cancer prognosis was also investigated.
METHODS
Microsatellite status was identified by genotyping. The clinicopathologic differences between two groups (MSI-H vs. MSI-L/S) and the prognostic value of MSI were analyzed.
RESULTS
From 1993 to 2006, 709 sporadic colon cancer patients were enrolled. MSI-H colon cancers showed significant association with poorly differentiated (28.3% vs. 7.2%, p = 0.001), proximally located (76.7% vs. 34.5%, p = 0.001), more high mucin-containing tumor (10.0% vs. 5.1%, p = 0.001) and female predominance (56.7% vs. 30.2%, p = 0.001). In multivariate analysis, MSI-H is an independent factor for better overall survival (HR, 0.459; 95% CI, 0.241-0.872, p = 0.017).
CONCLUSIONS
Based on the hospital-based study, MSI-H colon cancers demonstrated distinguished clinicopathologic features from MSI-L/S colon cancers. MSI-H is an independent favorable prognostic factor for overall survival in colon cancer.
目的
本研究旨在评估散发性微卫星不稳定（MSI）高（MSI-H）结肠癌的发病率并阐明其临床病理特征。此外，还探讨了 MSI 在结肠癌预后中的作用。
方法
通过基因分型鉴定微卫星状态。分析两组（MSI-H 与 MSI-L/S）之间的临床病理差异以及 MSI 的预后价值。
结果
1993 年至 2006 年期间，共纳入 709 例散发性结肠癌患者。MSI-H 结肠癌与低分化（28.3% vs. 7.2%，p=0.001）、近端位置（76.7% vs. 34.5%，p=0.001）、更多高粘蛋白含量肿瘤（10.0% vs. 5.1%，p=0.001）和女性为主（56.7% vs. 30.2%，p=0.001）显著相关。多因素分析显示，MSI-H 是总体生存的独立有利因素（HR，0.459；95%CI，0.241-0.872，p=0.017）。
结论
基于基于医院的研究，MSI-H 结肠癌与 MSI-L/S 结肠癌具有明显不同的临床病理特征。MSI-H 是结肠癌总体生存的独立预后因素。
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