首页|结直肠癌错配修复缺陷的影响因素分析

结直肠癌错配修复缺陷的影响因素分析

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目的 探讨结直肠癌(colorectal cancer,CRC)错配修复(mismatch repair,MMR)缺陷的影响因素.方法 选取2019 年 10 月至 2023 年 3 月湖州市第一人民医院和 2020 年 7 月至 2022 年 9 月湖州市中心医院治疗的 808 例CRC患者为研究对象.根据CRC患者的诊断年龄,将<50 岁患者作为早发性CRC组(57 例),≥50 岁患者作为晚发性CRC组(751例).通过免疫组化染色检测结直肠组织中 MMR 蛋白的表达情况,分析 MMR 蛋白表达缺失的影响因素.结果 MMR蛋白表达缺失率为 6.8%.单因素分析显示,与MMR完整患者比较,MMR缺陷患者的年龄显著降低,右半结肠病灶占比、Ki67 阳性细胞率均显著升高,肿瘤长径显著增长,分化显著变差,淋巴结转移显著减少,TNM分期显著变早(P<0.05).Logistic回归多因素分析显示,年龄、肿瘤部位、肿瘤长径和Ki67 阳性细胞率是结直肠癌患者MMR蛋白表达缺失的独立影响因素(P<0.05).早发性CRC组患者的MMR缺陷占比显著高于晚发性CRC组(P<0.05).结论 MMR蛋白表达缺失的CRC患者以发病年龄低、右半结肠多、肿瘤长径长和Ki67 阳性细胞率高为特点.
Analysis of influencing factors of deficient mismatch repair in colorectal cancer
Objective To investigate influencing factors of deficient mismatch repair(MMR)in colorectal cancer(CRC).Methods A total of 808 patients with CRC treated in the First People's Hospital of Huzhou from October 2019 to March 2023 and Huzhou Central Hospital from July 2020 to September 2022 were selected as the research objects.According to the diagnosis age of CRC patients,under 50 years old patients as early onset CRC group(57 patients),and over 50 years old patients as late onset CRC group(751 patients).Expression of MMR protein in colorectal tissue was detected through immunohistochemical staining.Influencing factor of MMR protein expression deficiency was analyzed.Results Rate of MMR protein deficiency was 6.8%.Univariate analysis showed that compared with proficient MMR patients,deficient MMR patients had significantly lower age,significantly higher proportion of lesions in the right colon,significantly higher Ki67 positive cell rate,significantly longer tumor length,significantly worse differentiation,significantly fewer lymph node metastases,and significantly earlier TNM stage(P<0.05).Logistic regression multivariate analysis showed that age,tumor location,tumor length,and Ki67 positive cell rate were independent influencing factors for the loss of MMR protein expression in colorectal cancer patients(P<0.05).Proportion of MMR defects in early onset CRC group was significantly higher than that in late onset CRC group(P<0.05).Conclusion CRC patients with MMR protein expression deficiency are characterized by younger onset age,more right colon,longer tumor length and higher Ki67 positive cell rate.

Colorectal cancerMismatch repairPathological characteristicsInfluencing factor

毛立祺、魏强、于冬冬、戴董吉

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湖州市第一人民医院消化内科,浙江湖州 313000

湖州市中心医院普外科,浙江湖州 313000

湖州市中心医院泌尿外科,浙江湖州 313000

湖州市第一人民医院病理科,浙江湖州 313000

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结直肠癌 错配修复 病理特征 影响因素

湖州市科技计划

2022GYB05

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(15)
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