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结直肠癌Ⅱ期和Ⅲ期患者中 MMR 蛋白免疫组化异质表达的重要性。

The Importance of Immunohistochemical Heterogeneous Expression of MMR Protein in Patients with Colorectal Cancer in Stage II and III of the Disease.

机构信息

Department of Pathology, Faculty of Medicine, Clinical Centre Niš, University of Niš, 18 000 Niš, Serbia.

Department of Histology and Embryology, Faculty of Medicine, University of Niš, 18 000 Niš, Serbia.

出版信息

Medicina (Kaunas). 2023 Mar 2;59(3):489. doi: 10.3390/medicina59030489.

DOI:10.3390/medicina59030489
PMID:36984490
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10051778/
Abstract

: In patients with colorectal cancer (CRC), heterogeneous expression of Mismatch repair (MMR) proteins can manifest itself in several different forms and is not such a rare phenomenon. Therefore, it is very important to recognize the nuclear expression of MMR proteins of different MMR status in order to avoid false positive or false negative results. The aim of this study was to determine the frequency and distribution of heterogeneous expression of MMR proteins in patients with stages II and III of the disease as well as its association with clinical, demographic and pathological characteristics of CRC in relation to proficient and deficient expression of MMR proteins. : The study included 104 cases of colorectal cancer obtained from surgical colectomy material in stages II and III of the disease. From a total of 104 patients with colorectal cancer, immunohistochemical analysis of the expression of all four MMR proteins showed that heterogeneous expression of MMR proteins (as well as deficient immunoreactivity of tumor cells) was present in 12 cases, while proficient expression of MMR proteins was detected in 80 tumors. : Our study showed that the only independent predictors of the loss of MMR protein expression were younger patient age and right-sided anatomical location of the tumor. The study also established the existence of heterogeneous expression of MMR proteins in a non-negligible percentage of CRCs (11.5%), where heterogeneous nuclear expression of MMR proteins was described in several different forms.

摘要

在结直肠癌（CRC）患者中，错配修复（MMR）蛋白的异质性表达可能表现为几种不同的形式，且并不罕见。因此，识别不同 MMR 状态下 MMR 蛋白的核表达对于避免假阳性或假阴性结果非常重要。本研究旨在确定 II 期和 III 期 CRC 患者中 MMR 蛋白异质性表达的频率和分布，以及其与 MMR 蛋白表达是否充分的临床、人口统计学和病理学特征之间的关系。

该研究纳入了 104 例来自 II 期和 III 期结直肠手术切除标本的结直肠癌病例。在总共 104 例结直肠癌患者中，对所有四种 MMR 蛋白的免疫组织化学分析显示，12 例存在 MMR 蛋白异质性表达（以及肿瘤细胞免疫反应性缺乏），而 80 例肿瘤中存在 MMR 蛋白充分表达。

我们的研究表明，MMR 蛋白表达缺失的唯一独立预测因子是患者年龄较小和肿瘤的右侧解剖位置。该研究还证实，在相当一部分 CRC 中存在 MMR 蛋白的异质性表达（11.5%），其中 MMR 蛋白的核异质性表达表现为几种不同的形式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/16abb408528a/medicina-59-00489-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/ff012ba859d7/medicina-59-00489-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/59409749825f/medicina-59-00489-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/e56e2ade000b/medicina-59-00489-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/51abe5b7bd6b/medicina-59-00489-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/16abb408528a/medicina-59-00489-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/ff012ba859d7/medicina-59-00489-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/59409749825f/medicina-59-00489-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/e56e2ade000b/medicina-59-00489-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/51abe5b7bd6b/medicina-59-00489-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ac5/10051778/16abb408528a/medicina-59-00489-g005.jpg

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Mod Pathol. 2023 Feb;36(2):100012. doi: 10.1016/j.modpat.2022.100012. Epub 2023 Jan 10.
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Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.全球癌症统计数据 2018：GLOBOCAN 对全球 185 个国家/地区 36 种癌症的发病率和死亡率的估计。
CA Cancer J Clin. 2018 Nov;68(6):394-424. doi: 10.3322/caac.21492. Epub 2018 Sep 12.
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