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结直肠癌中微卫星不稳定性的临床病理结局。

Clinicopathological outcomes of microsatellite instability in colorectal cancer.

机构信息

Department of General Surgery, Istanbul Sultanbeyli State Hospital, Istanbul, Turkey.

Department of General Surgery, Istanbul Sultan 2, Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

出版信息

J Cancer Res Ther. 2024 Jan 1;20(1):103-111. doi: 10.4103/jcrt.jcrt_1560_22. Epub 2022 Nov 14.

Abstract

AIMS

This study aims to evaluate the histopathological features and prognostic parameters of tumors with microsatellite instability (MSI) compared with those without MSI in patients who underwent surgery for colorectal cancer (CRC).

SETTING AND DESIGN

Follow-up for CRC at Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital was retrospectively evaluated between March 2017 and March 2021.

METHODS AND MATERIAL

The patients were divided into two groups: those with and without MSI. Groups were compared in survival parameters. As a secondary result, groups were compared in pathological parameters such as stage, tumor diameter, degree of differentiation, and lymphovascular, and perineural invasion.

STATISTICAL ANALYSIS USED

Survival calculations were performed using the Kaplan-Meier analysis method. The effects of various prognostic factors related to tumor and patient characteristics on disease-free and overall survival (OS) were investigated by log-rank test.

RESULTS

Two hundred fourteen patients were analyzed. The median age of the patients was 66 (30-89), and 59.3% (n = 127) were male. There were 25 patients in the MSI group and 189 patients in the non-MSI group. We found that MSI tumors had a significantly higher differentiation degree than non-MSI tumors and larger tumor diameters. MSI tumors frequently settled in the proximal colon, and more lymph nodes were removed in the resection material. MSI tumors had longer disease-free survival, cancer-specific survival, and overall survival.

CONCLUSIONS

By diagnosing microsatellite instability, CRCs can be divided into two groups. The histopathological features of the tumor and the prognosis of the disease differ between these groups. MSI can be a predictive marker in the patient's follow-up and treatment.

摘要

目的

本研究旨在评估接受结直肠癌(CRC)手术的患者中,微卫星不稳定(MSI)与非 MSI 肿瘤的组织病理学特征和预后参数。

设置和设计

对 2017 年 3 月至 2021 年 3 月在伊斯坦布尔苏丹 2. 阿卜杜勒哈米德·汉培训和研究医院接受 CRC 随访的患者进行回顾性评估。

方法和材料

患者被分为两组:有 MSI 和无 MSI。对两组的生存参数进行比较。作为次要结果,对两组的病理参数(如分期、肿瘤直径、分化程度、血管淋巴管和神经周围侵犯)进行比较。

统计分析方法

使用 Kaplan-Meier 分析方法进行生存计算。通过对数秩检验研究与肿瘤和患者特征相关的各种预后因素对无病和总生存(OS)的影响。

结果

分析了 214 例患者。患者的中位年龄为 66 岁(30-89 岁),59.3%(n=127)为男性。MSI 组有 25 例患者,非 MSI 组有 189 例患者。我们发现 MSI 肿瘤的分化程度明显高于非 MSI 肿瘤,肿瘤直径也更大。MSI 肿瘤常位于近端结肠,切除标本中切除的淋巴结更多。MSI 肿瘤无病生存、癌症特异性生存和总生存时间更长。

结论

通过诊断微卫星不稳定性,CRC 可以分为两组。这两组肿瘤的组织病理学特征和疾病预后不同。MSI 可以作为患者随访和治疗的预测标志物。

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