Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer
Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer
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DOI：
10.1056/nejm200001133420201
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发表时间：
2000-01-13
影响因子：
158.5
通讯作者：
Gallinger, S
中科院分区：
文献类型：
--
作者：
Gryfe, R;Kim, H;Gallinger, S
背景：结直肠癌可以通过两种不同的突变途径发生：微卫星不稳定性或染色体不稳定性。我们测试的假设，结直肠癌所产生的微卫星不稳定性通路具有独特的临床属性，影响临床outcome.Methods：我们测试了标本的结直肠癌从一个基于人群的系列607例患者（50岁或以下的诊断）的微卫星不稳定性。我们比较了以高频率微卫星不稳定性为特征的结直肠癌患者的临床特征和生存率，以及以微卫星稳定性为特征的结直肠癌患者的这些特征。我们在607例结直肠癌患者中发现了17%的高频率微卫星不稳定性，在多变量分析中，微卫星不稳定性与显著的生存优势相关，独立于所有标准预后因素，包括肿瘤分期（风险比，0.42; 95%置信区间，0.27至0.67; P
Background: Colorectal cancer can arise through two distinct mutational pathways: microsatellite instability or chromosomal instability. We tested the hypothesis that colorectal cancers arising from the microsatellite-instability pathway have distinctive clinical attributes that affect clinical outcome.Methods: We tested specimens of colorectal cancer from a population-based series of 607 patients (50 years of age or younger at diagnosis) for microsatellite instability. We compared the clinical features and survival of patients who had colorectal cancer characterized by high-frequency microsatellite instability with these characteristics in patients who had colorectal cancers with microsatellite stability.Results: We found high-frequency microsatellite instability in 17 percent of the colorectal cancers in 607 patients, and in a multivariate analysis, microsatellite instability was associated with a significant survival advantage independently of all standard prognostic factors, including tumor stage (hazard ratio, 0.42; 95 percent confidence interval, 0.27 to 0.67; P