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微卫星不稳定性在胃癌中的预后影响

Prognostic impact of microsatellite instability in gastric cancer.

作者信息

Zepeda-Najar Cesar, Palacios-Astudillo Rodrigo Xavier, Chávez-Hernández Jazmín Danaé, Lino-Silva Leonardo Saul, Salcedo-Hernández Rosa A

机构信息

Surgical Oncology Division, Hospital Ángeles Tijuana, Mexico.

Surgical Pathology, Instituto Nacional de Cancerología de México, Mexico.

出版信息

Contemp Oncol (Pozn). 2021;25(1):68-71. doi: 10.5114/wo.2021.104939. Epub 2021 Feb 23.

Abstract

Gastric cancer is a common and deadly cancer. Several factors are associated with its prognosis; however, controversy exists about the role of microsatellite instability (MSI). We aimed to determine the 5-year overall survival (OS) of MSI in gastric adenocarcinoma. A cross-sectional study was carried out on gastric adenocarcinoma in clinical stages I to III treated with D2 gastrectomy between 2010-2013. MSI was demonstrated by immunohistochemistry. We performed a survival analysis comparing cases with and without MSI. From 102 cases, 9.8% showed MSI. The median age was 63 years (range 33-91 years), and 57.8% were men. The more prevalent site of occurrence was the antrum (46.1%), 78.5% of the cases presented in stage III, 47.1% were of the diffuse type, 45.1% were of an intestinal type, and 7.8% were mixed. MSI cases were associated with lower clinical stages (stages I-II) and with better 5-year OS (100 vs. 47 months, = 0.017). In a multivariate analysis, MSI was independently associated with better survival (HR = 0.209, 95% CI: 0.046-0.945, = 0.042). MSI gastric cancers presented in early clinical stages and had favourable prognosis compared with non-MSI cancers.

摘要

胃癌是一种常见且致命的癌症。有几个因素与其预后相关;然而,关于微卫星不稳定性(MSI)的作用仍存在争议。我们旨在确定胃腺癌中MSI的5年总生存率(OS)。对2010年至2013年间接受D2胃切除术治疗的临床I至III期胃腺癌进行了一项横断面研究。通过免疫组织化学检测MSI。我们进行了生存分析,比较有和没有MSI的病例。在102例病例中,9.8%显示MSI。中位年龄为63岁(范围33 - 91岁),57.8%为男性。最常见的发病部位是胃窦(46.1%),78.5%的病例为III期,47.1%为弥漫型,45.1%为肠型,7.8%为混合型。MSI病例与较低的临床分期(I - II期)相关,且5年OS更好(100个月对47个月,P = 0.017)。在多变量分析中,MSI与更好的生存率独立相关(HR = 0.209,95%CI:'0.046 - 0.945,P = 0.042)。与非MSI癌症相比,MSI胃癌临床分期较早且预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d961/8063893/fbf6b06deea2/WO-25-43693-g001.jpg

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