Microsatellite instability in poorly differentiated adenocarcinomas of the colon and rectum: relationship to clinicopathological features
Microsatellite instability in poorly differentiated adenocarcinomas of the colon and rectum: relationship to clinicopathological features
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DOI：
10.1136/jcp.2006.039081
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发表时间：
2007-06-01
影响因子：
3.4
通讯作者：
Nagawa, Hirokazu
中科院分区：
文献类型：
--
作者：
Kazama, Yoshihiro;Watanabe, Toshiaki;Nagawa, Hirokazu
背景资料：结肠直肠低分化腺癌（Por）是各种类型结肠直肠癌中预后最差的一种。Por与微卫星不稳定性（MSI）密切相关，而MSI与结直肠癌的预后密切相关，目的：探讨MSI对Por患者临床病理特征和生存期的影响。从肿瘤切片和相应的正常组织中提取的DNA通过PCR在五个微卫星位点进行分析：BAT 25，BAT 26，D2 S123，D5 S346和D17 S250。在两个或更多个基因座具有改变的肿瘤被归类为MSI-Por。其余的被归类为微卫星稳定性（MSS）-Por。结果：53例患者中，12例（22.6%）为MSI-Por，41例（77.4%）为MSS-Por。MSI-Por和MSS-Por在以下临床病理特征方面存在显着差异：年龄、性别、淋巴结转移（MSI-Por：4/12; MSS-Por：33/41）、TNM分期（MSI-Por：T1/T2/T3/T4 = 2/6/2/2; MSS-Por：3/3/19/16）和淋巴管浸润（MSI-Por：4/10; MSS-Por：27/35）。Kaplan-Meier生存曲线和log-rank分析显示，MSI-Por与MSS-Por相比，预后更好，但无显著性差异。结论：与MSS-Por相比，MSI-Por具有淋巴结转移率低、分期低的特点。这表明MSI-Por是一种攻击性较低的亚型。
Background: Poorly differentiated adenocarcinomas of the colon and rectum (Por) feature the worst prognosis among the various types of colorectal carcinomas. Por is highly associated with microsatellite instability (MSI), although MSI is associated with an improved prognosis in colorectal cancers.Aim: To investigate the influence of MSI on clinicopathological features and survival of patients affected by Por.Methods: 53 patients affected by Por were investigated. DNA extracted from tumour sections and the corresponding normal tissue was analysed by PCR at five microsatellite loci: BAT25, BAT26, D2S123, D5S346 and D17S250. Tumours with alterations at two or more loci were classified as MSI-Por. The others were classified as microsatellite stability (MSS)-Por. The clinicopathological features and survival of patients with MSI-Por and MSS-Por were investigated.Results: Of the 53 patients who were examined, 12 (22.6%) were MSI-Por, whereas 41 (77.4%) were MSS-Por. Significant differences were found between MSI-Por and MSS-Por regarding the following clinicopathological features: age, gender, lymph-node metastasis (MSI-Por: 4/12; MSS-Por: 33/41), TNM stage (MSI-Por: T1/T2/T3/T4 = 2/6/2/2; MSS-Por: 3/3/19/16) and lymphatic invasion (MSI-Por: 4/10; MSS-Por: 27/35). Kaplan-Meier survival curves and log-rank analysis showed that MSI-Por was associated with better prognosis than MSS-Por, although no significant difference was found.Conclusions: Compared with MSS-Por, MSI-Por is significantly associated with a low incidence of lymph-node metastases and a low stage. This indicates that MSI-Por is a less aggressive subtype.