错配修复基因在右半结肠癌的表达对病理特征的影响

doi:10.16139/j.1007-9610.2021.01.013

摘要/Abstract

摘要：

目的：研究散发性结肠癌错配修复基因MLH1、MSH2、MSH6和PMS2在右半结肠癌的蛋白质表达缺失情况,进一步分析错配修复基因的表达缺失与右半结肠癌病理特征的相关性。方法：收集2015年1月至2020年8月期间,在我院就诊的206例结肠癌病人手术切除组织标本及病历资料,左半结肠癌116例,右半结肠癌90例。应用免疫组织化学检测MLH1、MSH2、MSH6和PMS2基因的蛋白质表达情况,分析错配修复基因的蛋白质表达缺失与结肠癌病理特征的相关性。结果：错配修复基因在右半结肠癌的蛋白质表达缺失率高于左半结肠癌。右半结肠癌错配修复基因的蛋白质表达缺失与肿瘤分化程度、肿瘤神经浸润显著相关（P<0.05）。结论：散发性结肠癌中右半结肠癌病人错配修复基因的蛋白质表达缺失比例高于左半结肠癌。错配修复基因的蛋白质表达缺失右半结肠癌病人分化程度低,不易发生神经浸润。

关键词: 错配修复基因, 病理, 结肠癌

Abstract:

Objective To investigate the defect of expression of mismatch repair genes(MMR) including MLH1, MSH2, MSH6 and PMS2 in sporadic colon cancer, and analyze the expression of MMR related to pathological change of patients with right colon cancer. Methods The data of 206 patients with colon cancer including 116 cases with left colon cancer and 90 cases with right colon cancer in our hospital were collected from January 2015 to August 2020. The expression of MMR including MLH1, MSH2, MSH6 and PMS2 was detected by immunohistochemistry. The relation of defect in expression of MMR to pathological changes in colon cancer was analyzed. Results The rate of expression defect of MMR in patients with right colon cancer was higher than that in patients with left colon cancer. The expression defect of MMR was significantly related to tumor differentiation and neural invasion in patients with right colon cancer (P<0.05). Conclusions Higher rate of expression defect of MMR in patients with sporadic right colon cancer was present compared with the patients of left colon cancer. The patients of right colon cancer with expression defect of MMR have poorly pathological differentiated and are unprone to perineural invasion.

Key words: Mismatch repair gene, Pathology, Colon cancer

中图分类号:

R735.35

严万能, 马海洁, 沈朝敏. 错配修复基因在右半结肠癌的表达对病理特征的影响[J]. 外科理论与实践, 2021, 26(01): 62-65.

YAN Wanneng, MA Haijie, SHEN Chaomin. Effect of mismatch repair genes expression in right colon cancer on pathological characteristics[J]. Journal of Surgery Concepts & Practice, 2021, 26(01): 62-65.

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组别	MMR缺失	MMR表达	MLH1缺失	MSH2缺失	MSH6缺失	PMS2缺失
右半结肠癌（n=90）	12（13.33）	78	9（10.00）	3（3.33）	3（3.33）	9（10.00）
左半结肠癌（n=116）	9（7.76）	107	6（5.17）	3（2.59）	3（2.59）	6（5.17）
合计	21（10.19）	185	15	6	6	15

项目	病例数（n=90）	MMR表达		χ²值	P值
项目	病例数（n=90）	缺失（n=12）	表达（n=78）	χ²值	P值
性别
男	40	5(41.67%)	35(44.87%)	0.043	0.835
女	50	7(58.33%)	43(55.13%)
年龄（岁）
>50	81	9(75.00%)	72(92.31%)	1.806	0.179
≤50	9	3(25.00%)	6(7.69%)
肿瘤分化
低	19	7(58.33%)	12(15.38%)	9.711	0.012^a)
中	65	5(41.67%)	60(76.92%)
高	1	0	1(1.28%)
黏液腺癌	5	0	5(6.41%)
神经浸润
否	68	12(100%)	56(71.79%)	-	0.034^a)
是	22	0	22(28.21%)
脉管浸润
否	65	9(77.30%)	56（71.79%）	0.000	1.000
是	25	3（22.70%）	22（28.21%）
淋巴转移
否	45	5（41.67%）	40（51.28%）	0.385	0.535
是	45	7（58.33%）	38（48.72%）
TNM分期
Ⅰ	12	1(8.33%)	11(14.10%)	0.354	0.838
Ⅱ	33	5(41.67%)	28(35.90%)
Ⅲ	45	6(50.00%)	39(50.00%)