Microsatellite Instability Is Associated with the Clinicopathologic Features of Gastric Cancer in Sporadic Gastric Cancer Patients
Microsatellite Instability Is Associated with the Clinicopathologic Features of Gastric Cancer in Sporadic Gastric Cancer Patients
复制标题
DOI：
10.5230/jgc.2010.10.4.149
复制
发表时间：
2010-12-01
影响因子：
2.5
通讯作者：
Lee, Kang Hong
中科院分区：
文献类型：
--
作者：
Kim, Shin Hyuk;Ahn, Byung Kyu;Lee, Kang Hong
目的：复制错误是肿瘤发生的重要机制。结直肠癌微卫星不稳定性(MSI-H)与多种肿瘤的发生发展有关。MSI-H对散发性胃癌患者发生多发性胃癌的影响尚未明确。本研究旨在揭示散发性胃癌的临床病理特征与微血管密度的关系。材料与方法：2004年7月至2009年3月，128例散发性胃癌患者的临床病理特征，包括微血管密度(MSI)状态。所有患者均无遗传性非息肉病性结直肠癌家族史。结果：MSI-H癌的发生率为10.9%(14/128)。同期胃癌4例(3.1%)。14例MSI-H胃癌中有2例同时癌(14.3%)，2例MSS胃癌中有2例同时癌(1.8%；P=0.059，Fisher‘s精确检验)。在同期癌患者中，50%(2/4)的患者有MSI-H癌，而在无同步癌的患者中，9.7%(12/124)的患者有MSI-H癌。MSI-H(RR，24.7；95%CI1.5，与398.9相似；P=0.024)与同步胃癌有关，而与年龄、性别、家族史、组织学类型、部位、大体形态、大体大小、分期无关。结论：MSI与散发性胃癌患者肠型胃癌及多发胃癌的发生有关。在MSI-H胃癌患者中，需要特别注意同步和异时性多发癌的存在。
Purpose: Replication error is an important mechanism in carcinogenesis. The microsatellite instability (MSI-H) of colorectal cancers is associated with the development of multiple cancers. The influence of MSI-H on the development of multiple gastric cancers in sporadic gastric cancer patients has not been defined. This study was performed to reveal the association between the clinicopathologic features and MSI in sporadic gastric cancers.Materials and Methods: Between July 2004 and March 2009, the clinicopathologic characteristics, including MSI status, were evaluated in 128 consecutive patients with sporadic gastric cancers. None of the patients had hereditary non-polyposis colorectal cancer of familial gastric cancer. The markers that were recommended by the NCI to determine the MSI status for colorectal cancers were used.Results: MSI-H cancers were found in 10.9% of the patients (14/128). Synchronous gastric cancers were shown in 4 patients (3.1%). Synchronous cancers were found in 2 of 14 patients with MSI-H gastric cancer (14.3%) and 2 of 114 patients with MSS gastric cancer (1.8%; P=0.059, Fisher's exact test). Among the patients with synchronous cancer 50% (2/4) had MSI-H cancer, but 9.7% of the patients (12/124) without synchronous cancer had MSI-H cancer. MSI-H (RR, 24.7; 95% CI, 1.5 similar to 398.9; P=0.024) was related with to synchronous gastric cancer, but age, gender, family history, histologic type, location, gross morphology, size, and stage were not related to synchronous gastric cancer.Conclusions: MSI is associated with the intestinal-type gastric cancer and the presence of multiple gastric cancers in patients with sporadic gastric cancer. Special attention to the presence of synchronous and the development of metachronous multiple cancer in patients with MSI-H gastric cancer is needed.