Correlation study between MMR expression and microsatellite lesion status and prognosis level in colorectal cancer
[Objective]To analyze the correlation between the expression of mismatch repair(MMR)gene in colorectal cancer and the status and prognosis of microsatellite lesions.[Methods]This study focuses on 102 colorectal cancer patients admitted from July 2020 to July 2022.Based on immunohistochemical results,42 patients with MMR expression deficiency were classified as dMMR,and the remaining 60 patients with full MMR expression were classified as pMMR group.General and clinical data of the two groups of patients were collected and compared,and risk factors for MMR expression deficiency in colorectal cancer were summarized through statistical univariate analysis and logistic multiple regression analysis.All patients received first-line chemotherapy containing Oxaliplatin and were followed up for one year to compare the survival of the two groups after treatment.Spearman correlation coefficient was used to verify the correlation between MMR expression and microsatellite instability(MSI)and prognosis.[Results]The results of statistical univariate analysis showed that there were certain differences in age,lesion diameter,tumor differentiation,lymph node involvement in the tumor area,distant tumor metastasis,and microsatellite lesion status between the two groups of patients(P＜0.05).The results of logistic multiple factor regression analysis showed that age ≥60 years old,lesion diameter ≥5 cm,poorly differentiated tumor,unaffected regional lymph nodes,no distant metastasis of the tumor,and microsatellite lesion detection biomarkers＜40％or ≥40％(MSH-L or MSI-H)were the main influencing factors for the loss of MMR expression in colorectal cancer.After the first-line chemotherapy with Oxaliplatin,the objective response rate(ORR)of the pMMR group was 75.00％(45/60),the disease control rate(DCR)was 80.00％(48/60),the median progression-free survival(PFS)was 10.24±3.35 months,and the median overall survival(OS)was 11.46±2.49 months,which were higher than those of the dMMR group[52.38％(22/42),59.52％(25/42),8.28±3.14 months,and 10.33±2.02 months],and the MSI was 32.44％±5.18％,which was lower than that of the dMMR group 35.45％±5.26％(P＜0.05).According to Spearman correlation coefficient validation,MMR expression is negatively correlated with ORR,DCR,median PFS,and median OS in colorectal cancer,and positively correlated with MSI expression.[Conclusion]The absence of involvement of regional lymph nodes and the absence of distant metastasis,as well as MSI,are the main influencing factors leading to the loss of MMR expression in colorectal cancer.The loss of MMR expression can lead to MSI in colorectal cancer patients.If patients have dMMR or MSI,they should not be treated with first-line chemotherapy containing Oxaliplatin.
万方数据
维普
