Microsatellite instability in interval colon cancers
Microsatellite instability in interval colon cancers
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DOI：
10.1053/j.gastro.2006.10.022
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发表时间：
2006-12-01
期刊：
影响因子：
29.4
通讯作者：
Bond, John H.
中科院分区：
文献类型：
--
作者：
Sawhney, Mandeep S.;Farrar, William D.;Bond, John H.
背景与目的：完整结肠镜检查后发生的结肠癌可能是“结肠镜检查失败”或肿瘤快速生长的结果。通过错配修复基因途径产生的肿瘤表现出快速的肿瘤生长。本研究的目的是确定间期结肠癌是否比非间期结肠癌更有可能由错配修复基因功能丧失引起，从而证明微卫星不稳定性 (MSI)。方法：我们在我们机构的癌症登记处检索了间期癌症，其定义为在完整结肠镜检查后 5 年内发生的结肠癌。这些患者的年龄和性别与非间期癌症（定义为患者首次记录的结肠镜检查中诊断出的结肠癌）患者的频率匹配，比例为 1:2。检索所有受试者存档的癌症样本并进行 MSI 测试。结果：在研究期间诊断的 993 例结肠癌中，51 例（5.1%）被确定为间期癌，112 例非间期癌受试者作为对照组。研究对象几乎都是男性。 MSI 在 30.4% 的间期癌症中被发现，而在非间期癌症中这一比例为 10.3% (P=.003)。调整年龄后，间期癌症出现 MSI 的可能性是非间期癌症的 3.7 倍（95% 置信区间，13-9.1）。对于位于远端结肠的肿瘤，这种关联性最强（比值比，ITS；P=.008）。各组之间在诊断时的 TNM 分期、组织学类型或分级或 5 年生存率方面没有发现差异。结论：间期结肠癌与错配修复基因功能障碍相关的可能性几乎是非间期结肠癌的 4 倍。
Background & Aims: Colon cancers that develop after a complete colonoscopy may be the result of "failure of colonoscopy" or rapid tumor growth. Tumors that develop via the mismatch repair gene pathway demonstrate rapid tumor growth. The aim of this study was to determine if interval colon cancers were more likely than noninterval cancers to result from the loss of function of mismatch repair genes and hence demonstrate microsatellite instability (MSI). Methods: We searched our institution's cancer registry for interval cancers, defined as colon cancers that developed within 5 years of a complete colonoscopy. These were frequency matched in a 1:2 ratio by age and sex to patients with noninterval cancers (defined as colon cancers diagnosed on a patient's first recorded colonoscopy). Archived cancer specimens for all subjects were retrieved and tested for MSI. Results: Of the 993 colon cancers diagnosed during the study period, 51 (5.1%) were identified as an interval cancer, and 112 subjects with noninterval cancer served as a comparison group. Study subjects were almost all men. MSI was found in 30.4% of interval cancers compared with 10.3% of noninterval cancers (P=.003). After adjusting for age, interval cancers were 3.7 times more likely to show MSI than noninterval cancers (95% confidence interval, 13-9.1). This association was strongest for tumors located in the distal colon (odds ratio, ITS; P=.008). No difference in TNM stage at diagnosis, histologic type or grade, or 5-year survival was found between groups. Conclusions: Interval colon cancers were almost 4 times as likely as noninterval colon cancers to be associated with mismatch repair gene dysfunction.