Xiao Z T, Zhang R X, Zhao Y, Peng J H, Lu S X, Zhang H Z, Ding P R, Wu X J, Lu Z H, Li L R, Wan D S, Pan Z Z, Chen G
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou 510060, China.
Zhonghua Yi Xue Za Zhi. 2017 Apr 25;97(16):1248-1251. doi: 10.3760/cma.j.issn.0376-2491.2017.16.014.
To explore the expression of mismatch repair (MMR) proteins in sporadic colorectal cancer (SCRC) patients, and its association with clinicopathological characteristics of SCRC. Patients with histologically confirmed colorectal cancer were consecutively recruited between December 2011 and June 2015 at Sun Yat-sen University Cancer Center. The exclusion criteria included multiple primary colorectal tumors, hereditary colorectal cancer (including Lynch syndrome, familial adenomatous polyposis), and the patients without the MMR proteins status tested. A total of 2 684 patients were included. Correlations of MMR proteins status and patients' demographics (including gender, age), tumor characteristics (site and differentiation) and TNM staging (excluding 315 SCRC patients receiving neoadjuvant therapy) were investigated. The percentage of deficient MMR (dMMR) in these SCRC patients was 10.2%, and that of proficient MMR (pMMR) was 89.8%. The dMMR was more likely to be detected in younger (≤59 old years) SCRC patients compared to the elderly (>59 years) [12.7%(179/1 406)vs 7.5%(96/1 278), <0.001]. The dMMR rate in right colon cancer was significantly higher than that in left colon cancer and rectal cancer [22.7%(151/664)vs 7.2%(69/956)vs 5.2%(55/1 064), <0.001]. Among the various pathological types of SCRC, mucinous adenocarcinoma showed the highest rate of dMMR (24.4%), and neuroendocrine carcinoma the lowest rate of dMMR (0) (<0.001). In addition, the proportions of dMMR in stage Ⅰ, stage Ⅱ, stage Ⅲ and stage Ⅳ SCRC were 9.7%, 16.5%, 8.5%, and 3.9%, respectively (<0.001). There is no significant difference in the proportion of dMMR between male and female (11.0% vs 9.1%, =0.114). dMMR status may be most likely to exist in younger (≤59 years) patients with stage Ⅱ right colon mucinous adenocarcinoma among SCRC.
探讨错配修复（MMR）蛋白在散发性结直肠癌（SCRC）患者中的表达及其与SCRC临床病理特征的关系。2011年12月至2015年6月期间，中山大学肿瘤防治中心连续招募了组织学确诊为结直肠癌的患者。排除标准包括多发性原发性结直肠肿瘤、遗传性结直肠癌（包括林奇综合征、家族性腺瘤性息肉病）以及未检测MMR蛋白状态的患者。共纳入2684例患者。研究了MMR蛋白状态与患者人口统计学特征（包括性别、年龄）、肿瘤特征（部位和分化程度）以及TNM分期（不包括315例接受新辅助治疗的SCRC患者）之间的相关性。这些SCRC患者中错配修复缺陷（dMMR）的比例为10.2%，错配修复功能正常（pMMR）的比例为89.8%。与老年（>59岁）SCRC患者相比，年轻（≤59岁）SCRC患者更易检测到dMMR[12.7%（179/1406）对7.5%（96/1278），<0.001]。右半结肠癌的dMMR率显著高于左半结肠癌和直肠癌[22.7%（151/664）对7.2%（69/956）对5.2%（55/1064），<0.oo1]。在SCRC的各种病理类型中，黏液腺癌的dMMR率最高（24.4%），神经内分泌癌的dMMR率最低（0）（<0.001）。此外，Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期SCRC中dMMR的比例分别为9.7%、16.5%、8.5%和3.9%（<0.001）。男性和女性的dMMR比例无显著差异（11.0%对9.1%，=0.114）。dMMR状态最可能存在于SCRC中年龄≤59岁的Ⅱ期右半结肠黏液腺癌患者中。
