Qin Qiong, Ying Jianming, Lyu Ning, Guo Lei, Zhi Wenxue, Zhou Aiping, Wang Jinwan
Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
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Zhonghua Zhong Liu Za Zhi. 2015 Aug;37(8):591-6.
To explore the relationship between DNA mismatch repair (MMR) and clinicopathologic features and prognosis in patients with stages II and III colon cancers.
The clinical and pathological data of 440 patients with stage II/III colon cancer after radical resection were retrospectively reviewed and analyzed. Immunohistochemical staining was used to assess the expression of MMR proteins (MLH1, MSH2, MSH6 and PMS2), and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed.
Of the 440 tumor samples tested for DNA mismatch repair status, 90 (20.5%) demonstrated defective DNA mismatch repair and 350 (79.5%) had proficient DNA mismatch repair. Defective DNA mismatch repair (dMMR) was associated with young patients (≤ 60), proximal colon cancer, stage II, poorly differentiated adenocarcinoma and mucinous adenocarcinoma (P<0.05 for all). Among the 440 patients, 126 (28.6%) cases had recurrence or metastasis and 93 (21.1%) died during the median follow-up of 61.0 months. The five-year disease-free survival (DFS) rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR (68.9%, P=0.02). The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5-year disease-free survival and overall survival (OS) in colon cancer patients (P<0.05 for both).
Defective DNA mismatch repair (dMMR) is associated with patients with proximal colon cancer, stage II and poorly defferentiated adenocarcinoma and mucinous adenocarcinoma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.
探讨DNA错配修复（MMR）与II期和III期结肠癌患者临床病理特征及预后的关系。
回顾性分析440例II/III期结肠癌根治性切除术后患者的临床和病理资料。采用免疫组织化学染色评估MMR蛋白（MLH1、MSH2、MSH6和PMS2）的表达，并分析DNA错配修复与结肠癌临床病理特征及预后的相关性。
在检测DNA错配修复状态的440个肿瘤样本中，90个（20.5%）显示DNA错配修复缺陷，350个（79.5%）具有正常的DNA错配修复。DNA错配修复缺陷（dMMR）与年轻患者（≤60岁）、近端结肠癌、II期、低分化腺癌和黏液腺癌相关（均P<0.05）。440例患者中，126例（28.6%）出现复发或转移，93例（21.1%）在中位随访61.0个月期间死亡。肿瘤表现为dMMR的患者五年无病生存率（DFS）为82.2%，显著高于肿瘤表现为pMMR的患者（68.9%，P=0.02）。单因素和多因素分析显示，MMR状态是影响结肠癌患者5年无病生存率和总生存率（OS）的独立因素（均P<0.05）。
DNA错配修复缺陷（dMMR）与近端结肠癌、II期以及低分化腺癌和黏液腺癌患者相关。dMMR患者的预后优于pMMR患者。dMMR可能是结肠癌预后的一个有用生物标志物。
