Zhu Xueru, Wang Yiwei, Li Hongjia, Xue Wenji, Wang Ruifen, Wang Lifeng, Zhu Meiling, Zheng Leizhen
Department of Oncology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, Shanghai, China.
Department of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, 200092, Shanghai, China.
J Cancer. 2017 Jun 1;8(8):1477-1483. doi: 10.7150/jca.18487. eCollection 2017.
The aim of the study was to investigate the effect of deficiency of hMLH1 and hMSH2 expression on the prognosis of early gastric cancer (EGC) in Chinese populations. A total of 160 EGC patients who underwent curative gastrectomy with lymphadenectomy from January 2011 to July 2014 at Xinhua Hospital were evaluated. The expression rates of hMLH1 and hMSH2 were examined using tissues preserved in paraffin blocks by immunohistochemical staining. The clinicopathological characteristics and prognosis of EGC with deficient hMLH1 and hMSH2 were analyzed. On immunohistochemical staining, the loss expression of hMLH1 and hMSH2 were observed in 89 (55.6%) and 45 (28.1%), respectively. The hMLH1 deficiency was associated with the middle third of tumor location ( = 0.041). According to Kaplan-Meier survival analysis and Log-Rank test, the loss expression of hMLH1 and hMSH2 were associated with worse survival than positive hMLH1 (HR = 0.247, 95% CI = 0.078-0.781, = 0.017) and hMSH2 (HR = 0.174, 95% CI = 0.051-0.601, = 0.006) in EGC. The main conclusions were as follows: The hMLH1 deficiency was preferred to the middle third of EGC. Lymph node metastasis (LNM) was a prognostic factor of EGC. And the prognosis of EGC patients with deficient mismatch repair (dMMR, mainly including deficient hMLH1 and hMSH2) was obviously worse than proficient mismatch repair (pMMR).
本研究旨在探讨hMLH1和hMSH2表达缺失对中国人群早期胃癌（EGC）预后的影响。对2011年1月至2014年7月在新华医院接受根治性胃切除术及淋巴结清扫术的160例EGC患者进行评估。采用免疫组织化学染色法，利用石蜡包埋组织检测hMLH1和hMSH2的表达率。分析hMLH1和hMSH2缺失的EGC的临床病理特征及预后。免疫组织化学染色显示，hMLH1和hMSH2的缺失表达分别见于89例（55.6%）和45例（28.1%）。hMLH1缺失与肿瘤位于中三分之一部位有关（P = 0.041）。根据Kaplan-Meier生存分析和Log-Rank检验，hMLH1和hMSH2的缺失表达与EGC患者生存情况较差相关，而hMLH1阳性（HR = 0.247，95%CI = 0.078 - 0.781，P = 0.017）和hMSH2阳性（HR = 0.174，95%CI = 0.051 - 0.601，P = 0.006）的患者生存情况较好。主要结论如下：hMLH1缺失多见于EGC的中三分之一部位。淋巴结转移（LNM）是EGC的一个预后因素。错配修复缺陷（dMMR，主要包括hMLH1和hMSH2缺失）的EGC患者的预后明显差于错配修复功能正常（pMMR）的患者。
