Relationship between mismatch repair gene MMR and chemotherapy sensitivity in advanced colorectal cancer patients with prognosis
Objective To investigate the Relationship between mismatch repair gene MMR and chemotherapy sensitivity in advanced colorectal cancer patients with prognosis.Methods The clinicopathological data and prognosis of 100 advanced colorectal cancer patients who received standard chemotherapy in Gastrointestinal Surgery Department of Hennan Provincial People's Hospital from January 2010 to January 2015 were retrospectively analyzed.Immunohistochemistry was used to de-tect the protein expression of MLH1,PSM2,MSH2,and MSH6 in colorectal cancer tissues,and they were divided into pM-MR and dMMR groups to compare the chemotherapy sensitivity and prognosis of the two groups.Results Immunohistochemical staining showed that the positive expression of MMR protein was localized in the nucleus,and some of them were accompanied by weak staining of cytoplasm.Among them,14 patients(14.0％)were interpreted as missing MMR protein expression,namely dMMR.The other 86 patients(86％)were pMMR.MMR protein expression was associated with lymph node metastasis and metastasis of colorectal cancer,with statistically significant differences(all P＜0.05),but not with age,gender,tumor size and location,degree of differentiation,infiltration depth,serum CEA,etc.(all P＞0.05).According to the follow-up and evaluation of treatment effect,the treatment sensitivity rate of the dMMR group was 57.14％,and the treatment sensitivity rate of the pMMR group was 27.91％,which was statistically different(P＜0.05).Meanwhile,the survival prognosis of patients in the dMMR group was significantly longer than that in the pM-MR group,which had a statistically difference(OR:0.4465 95％CI 0.2443-0.8158 P＜0.05).Univariate and multiva-riate Cox regression model showed that infiltration,lymph node metastasis,distant metastasis,and MMR protein expression were independent factors for the overall survival of patients with advanced colorectal cancer(all P＜0.05).However,age,gender,tumor size,location,differentiation degree and serum CEA were not closely related to survival(P＞0.05).Conclusion MMR has a great significance for individualized immunotherapy in patients with advanced colorectal cancer.Different microsatellite states have their specific clinicopathological characteristics,and microsatellite status detection and immunohistochemical indexes have guiding effects on the treatment and prognosis of colorectal cancer.
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