Effects of microsatellite instability on recurrence patterns and outcomes in colorectal cancers.
Effects of microsatellite instability on recurrence patterns and outcomes in colorectal cancers.
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DOI：
10.1038/bjc.2016.161
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发表时间：
2016-06-28
影响因子：
8.8
通讯作者：
Shin SJ
中科院分区：
文献类型：
--
作者：
Kim CG;Ahn JB;Jung M;Beom SH;Kim C;Kim JH;Heo SJ;Park HS;Kim JH;Kim NK;Min BS;Kim H;Koom WS;Shin SJ
在结直肠癌（crc）中，与低频MSI或微卫星稳定性（MSI- l /MSS）相比，高频微卫星不稳定性（MSI- h）与更好的预后相关。然而，MSI是否影响复发性crc的预后尚不清楚。该研究包括2940例接受完全切除的I-III期结直肠癌患者。分析MSI状态与复发模式、无病生存期（DFS）、从诊断到死亡总生存期（OS1）和从复发到死亡总生存期（OS2）的关系。共有261例患者（8.9%）患有MSI-H型CRC。与MSI-L/MSS CRC患者相比，MSI-H CRC患者的DFS更好（风险比（HR）： 0.619， P<0.001）。高频微卫星不稳定性结直肠癌与更频繁的局部复发（30.0%比12.0%，P=0.032）或腹膜转移（40.0%比12.3%，P=0.003）相关，而较少的肺转移（10.0%比42.5%，P=0.004）或肝转移（15.0%比44.7%，P=0.01）相关。复发的MSI-H CRC与较差的OS1 （HR: 1.363， P=0.035）和OS2 （HR: 2.667， P<0.001）相关。对结肠癌患者的分析也得出了类似的结果。MSI-H型CRC和MSI-L/MSS型CRC的复发模式不同，复发的MSI-H型CRC预后较差。
Among colorectal cancers (CRCs), high-frequency microsatellite instability (MSI-H) is associated with a better prognosis, compared with low-frequency MSI or microsatellite stability (MSI-L/MSS). However, it is unclear whether MSI affects the prognosis of recurrent CRCs. This study included 2940 patients with stage I–III CRC who underwent complete resection. The associations of MSI status with recurrence patterns, disease-free survival (DFS), overall survival from diagnosis to death (OS1), and overall survival from recurrence to death (OS2) were analysed. A total of 261 patients (8.9%) had MSI-H CRC. Patients with MSI-H CRC had better DFS, compared to patients with MSI-L/MSS CRC (hazard ratio (HR): 0.619, P<0.001). High-frequency microsatellite instability CRC was associated with more frequent local recurrence (30.0% vs 12.0%, P=0.032) or peritoneal metastasis (40.0% vs 12.3%, P=0.003), and less frequent lung (10.0% vs 42.5%, P=0.004) or liver metastases (15.0% vs 44.7%, P=0.01). Recurrent MSI-H CRC was associated with worse OS1 (HR: 1.363, P=0.035) and OS2 (HR: 2.667, P<0.001). An analysis of patients with colon cancer yielded similar results. Recurrence patterns differed between MSI-H CRC and MSI-L/MSS CRC, and recurrent MSI-H CRCs had a worse prognosis.