Clinical Significance and Prognostic Relevance of Microsatellite Instability in Sporadic Colorectal Cancer Patients.
Clinical Significance and Prognostic Relevance of Microsatellite Instability in Sporadic Colorectal Cancer Patients.
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DOI：
10.3390/ijms18010107
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发表时间：
2017-01-06
影响因子：
5.6
通讯作者：
Nowakowska-Zajdel E
中科院分区：
文献类型：
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作者：
Copija A;Waniczek D;Witkoś A;Walkiewicz K;Nowakowska-Zajdel E
微卫星不稳定性（MSI）是复制错误表型的标志。它是由 DNA 错配修复过程 (MMR) 受损引起的，导致负责 DNA 复制精度和复制后 DNA 修复的机制无效。 MSI 是 10%–20% 结直肠癌 (CRC) 病例发病机制的基础。关于 MMR 状态作为基于 5-氟尿嘧啶 (FU) 的化疗的预测因素的潜在价值的数据仍不清楚。根据美国国家综合癌症网络更新指南，建议所有 II 期 CRC 患者进行 MSI 检测，因为 MSI-H（高频 MSI）肿瘤患者可能预后良好，并且无法从基于 5-FU 的辅助化疗中获益。 MSI 状态作为转移性疾病患者预测因素的重要性尚未得到证实。 MSI 状态与基于抗程序性死亡 1 受体抑制剂的治疗效果之间的关联需要进一步研究。
Microsatellite instability (MSI) is a marker of the replication error phenotype. It is caused by impaired DNA mismatch repair processes (MMR), resulting in ineffectiveness of the mechanisms responsible for the DNA replication precision and postreplicative DNA repair. MSI underlies the pathogenesis of 10%–20% of colorectal cancer (CRC) cases. The data about the potential value of MMR status as a predictive factor for 5-fluorouracil (FU)-based chemotherapy remain unclear. According to National Comprehensive Cancer Network updated guidelines, MSI testing is recommended for all patients with stage II CRC because patients with MSI-H (high-frequency MSI) tumour may have a good prognosis and obtain no benefit from 5-FU-based adjuvant chemotherapy. The significance of the MSI status as a predictive factor for patients with metastatic disease was not confirmed. The association between the MSI status and the efficacy of the therapy based on anti-programmed death-1 receptor inhibitors requires further studies.