Kim Young Beak, Lee Sun-Young, Kim Jeong Hwan, Sung In-Kyung, Park Hyung Seok, Shim Chan Sup, Han Hye Seung
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
Gut Liver. 2016 Mar;10(2):220-7. doi: 10.5009/gnl14310.
BACKGROUND/AIMS: Microsatellite instability (MSI) plays a crucial role in gastrointestinal carcinogenesis. The aim of this study was to clarify whether MSI is a useful marker for predicting synchronous gastric and colorectal neoplasms.
Consecutive patients who underwent both esophagogastroduodenoscopy and colonoscopy before the resection of gastric or colorectal cancers were included. MSI was analyzed using two mononucleotide and three dinucleotide markers.
In total, 434 gastric cancers (372 microsatellite stability [MSS], 21 low incidence of MSI [MSI-L], and 41 high incidence of MSI [MSI-H]) and 162 colorectal cancers (138 MSS, 9 MSI-L, and 15 MSI-H) were included. Patients with MSI gastric cancer had a higher prevalence of synchronous colorectal cancer, colorectal adenoma, and gastric adenoma than those with MSS gastric cancers (4.8% vs 0.5%, p=0.023; 11.3% vs 3.2%, p=0.011; 3.2% vs 1.2%, p=0.00, respectively). The prevalence of synchronous colorectal adenomas was highest in MSI-L gastric cancers (19.0%), compared with MSI-H (7.3%) or MSS (3.2%) gastric cancers (p=0.002). In addition, there were no significant differences in the prevalence rates of synchronous colorectal adenoma among the MSI-H (13.3%), MSI-L (11.1%), and MSS (12.3%) colorectal cancers (p=0.987).
The presence of MSI in gastric cancer may be a predictor of synchronous gastric and colorectal neoplasms, whereas MSI in colorectal cancer is not a predictor of synchronous colorectal adenoma.
背景/目的：微卫星不稳定性（MSI）在胃肠道肿瘤发生过程中起着关键作用。本研究旨在阐明MSI是否为预测同时性胃和结直肠肿瘤的有用标志物。
纳入在胃或结直肠癌切除术前接受了食管胃十二指肠镜检查和结肠镜检查的连续患者。使用两个单核苷酸和三个二核苷酸标记物分析MSI。
共纳入434例胃癌（372例微卫星稳定[MSS]，21例微卫星不稳定性低发[MSI-L]，41例微卫星不稳定性高发[MSI-H]）和162例结直肠癌（138例MSS，9例MSI-L，15例MSI-H）。与MSS胃癌患者相比，MSI胃癌患者同时性结直肠癌、结直肠腺瘤和胃腺瘤的患病率更高（分别为4.8%对0.5%，p = 0.023；11.3%对3.2%，p = 0.011；3.2%对1.2%，p = 0.00）。与MSI-H（7.3%）或MSS（3.2%）胃癌相比，MSI-L胃癌中同时性结直肠腺瘤的患病率最高（19.0%）（p = 0.002）。此外，MSI-H（13.3%）、MSI-L（11.1%）和MSS（12.3%）结直肠癌中同时性结直肠腺瘤的患病率无显著差异（p = 0.987）。
胃癌中MSI的存在可能是同时性胃和结直肠肿瘤的预测指标，而结直肠癌中的MSI不是同时性结直肠腺瘤的预测指标。
