Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India.
Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, India.
S Afr J Surg. 2022 Mar;60(1):22-27.
Colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer in the world. Microsatellite instability (MSI) has been found associated with CRC, especially in prognostication. The present study has been carried out to find the genetic instability as demonstrated by MSI and its clinicopathological correlation in north Indian patients.
This prospective study was carried out on 103 CRC patients admitted for surgery between 2014 and 2018. MSI testing was done using 5-panel markers (BAT25, BAT26, D2S123, D5S346, and D17S250) by standard polymerase chain reaction (PCR) technique. The various clinicopathological factors were analysed to see their association with MSI status and also their effect on survival. Univariate analysis was performed by using the 2-tailed Student's t-test for continuous non-normally distributed variables, and categorical variables were compared using the chi-square test. Multivariate correlation analysis was performed by logistic regression test using SPSS version 16.0 (IBM Corporation, Armonk, NY, USA). Kaplan-Meier analysis was done to detect the patient's survival. A -value < 0.05 was considered statistically significant.
The frequency of MSI in patient population that we studied was 41.7% (43/103). MSI tumours were significantly associated with family history (OR = 5.63, = 0.022*, 95% CI = 1.1-28.6) and tumour-infiltrating lymphocytes (TILS) (OR = 2.60, = 0.023*, 95% CI = 1.1-6.0). The patients surviving longer (< 5 years vs > 5 years) were found significantly associated with MSI-high (MSI-H) (OR = 3.76, = 0.029*, 95% CI = 1.2-4.5).
Family history of cancer and presence of TILS were significantly associated with the presence of MSI-H tumours; also, patients surviving more than 5 years had more MSI-H phenotype.
结直肠癌（CRC）是全球第三大致命性和第四大常见癌症。微卫星不稳定性（MSI）已被发现与 CRC 相关，特别是在预后方面。本研究旨在发现印度北部患者的遗传不稳定性，这种不稳定性表现为 MSI 及其与临床病理的相关性。
本前瞻性研究于 2014 年至 2018 年间对 103 例因手术入院的 CRC 患者进行，采用标准聚合酶链反应（PCR）技术，通过 5 个面板标志物（BAT25、BAT26、D2S123、D5S346 和 D17S250）进行 MSI 检测。分析各种临床病理因素与 MSI 状态的关系，以及它们对生存的影响。连续非正态分布变量采用双尾 Student's t 检验进行单变量分析，分类变量采用卡方检验进行比较。采用 SPSS 版本 16.0（IBM 公司，纽约州阿蒙克）的逻辑回归检验进行多变量相关性分析。采用 Kaplan-Meier 分析检测患者的生存情况。p 值<0.05 为统计学显著。
我们研究的患者人群中 MSI 的频率为 41.7%（43/103）。MSI 肿瘤与家族史（OR=5.63，=0.022*，95%CI=1.1-28.6）和肿瘤浸润淋巴细胞（TILS）（OR=2.60，=0.023*，95%CI=1.1-6.0）显著相关。存活时间较长（<5 年与>5 年）的患者与 MSI-高（MSI-H）显著相关（OR=3.76，=0.029*，95%CI=1.2-4.5）。
癌症家族史和 TILS 的存在与 MSI-H 肿瘤的存在显著相关；此外，存活时间超过 5 年的患者具有更多的 MSI-H 表型。
