微卫星不稳定性与胃癌患者根治性手术后的良好预后相关。
Microsatellite instability is associated with a better prognosis for gastric cancer patients after curative surgery.
机构信息
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
World J Surg. 2012 Sep;36(9):2131-8. doi: 10.1007/s00268-012-1652-7.
BACKGROUND
Microsatellite instability (MSI) is one of the leading mechanisms for the carcinogenesis of gastric cancer. Its prognostic value is controversial.
METHODS
Between May 1988 and Oct 2003, a total of 214 gastric cancer patients undergoing curative surgery were enrolled, and their MSI statuses were classified as MSI-H (high) or MSI-L/S (low/stable). The clinicopathologic characteristics of MSI-H and MSI-L/S gastric cancers were compared.
RESULTS
The MSI-H tumors accounted for 11.7 % (n = 25) of the 214 total gastric cancers. Although not statistically significant, the MSI-H gastric cancers were more frequently located in the lower third of the stomach (64 % vs. 49.2 %) and were more often the intestinal type (72 % vs. 61.4 %) compared to the MSI-L/S gastric cancers. The MSI-H gastric cancers had a significantly better 5-year overall survival (OS) rate (68 % vs. 47.6 %, p = 0.030) and a trend of a better 3-year disease-free survival rate (71.8 % vs. 55.2 %, p = 0.076) compared to the MSI-L/S gastric cancers. A multivariate analysis revealed that pathologic TNM stage and MSI status were the independent prognostic factors for OS after curative surgery.
CONCLUSIONS
Compared to MSI-L/S tumors, MSI-H tumors are associated with a better OS rate for gastric cancer patients after R0 resection.
背景
微卫星不稳定性（MSI）是胃癌发生的主要机制之一。其预后价值存在争议。
方法
1988 年 5 月至 2003 年 10 月，共纳入 214 例接受根治性手术的胃癌患者，并将其 MSI 状态分为 MSI-H（高）或 MSI-L/S（低/稳定）。比较 MSI-H 和 MSI-L/S 胃癌的临床病理特征。
结果
MSI-H 肿瘤占 214 例胃癌的 11.7%（n=25）。尽管无统计学意义，但与 MSI-L/S 胃癌相比，MSI-H 胃癌更常位于胃的下三分之一（64%比 49.2%），且更常为肠型（72%比 61.4%）。与 MSI-L/S 胃癌相比，MSI-H 胃癌的 5 年总生存率（OS）明显更好（68%比 47.6%，p=0.030），且无病生存率（DFS）也有更好的趋势（71.8%比 55.2%，p=0.076）。多因素分析显示，病理 TNM 分期和 MSI 状态是根治性手术后 OS 的独立预后因素。
结论
与 MSI-L/S 肿瘤相比，MSI-H 肿瘤与胃癌患者 R0 切除后更好的 OS 率相关。
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