摘要
微卫星不稳定性(microsatellite instability,MSI)是指由于复制错误造成的微卫星重复的数目改变,其发生机制为错配修复缺陷。结直肠癌患者中有15%~20%为MSI高的患者。根据美国国家综合癌症网络发布的最新相关指南,建议对所有结直肠癌患者均使用聚合酶链反应法或免疫组织化学法进行MSI/错配修复检测。错配修复蛋白是诊断Lynch综合征的关键分子标志物。MSI高的结直肠癌患者的预后相对较好,但MSI高的Ⅱ期患者无法自氟尿嘧啶辅助化疗中获益。目前已见有抗程序性死亡受体-1单克隆抗体治疗MSI高的转移性结直肠癌患者疗效较好的报告,但此结论仍需得到大型临床试验的确认。
Microsatellite instability （MSI） is the change of the number of microsatellites, which is caused byreplication error, and its mechanism is defciency of mismatch repair （MMR）. About 15% - 20% of patients with colorectal cancer（CRC） are MSI high （MSI-H） patients. According to the latest National Comprehensive Cancer Network guidelines, it is highlyrecommended that all patients with CRC should detect MSI/MMR via polymerase chain reaction or immunohistochemistryMMR proteins are key markers for diagnosis of Lynch syndrome. Patients with MSI-H have a better prognosis, but those withstage II MSI-H tumors are not able to beneft from fuorouracil-based therapy. At present, anti-programmed cell death protein-1monoclonal antibodies have been applied to metastatic MSI-H colorectal cancer patients, which has achieved better efcacy, butlarge trials are still needed to verify these efects.
出处
《上海医药》
CAS
2018年第1期8-13,共6页
Shanghai Medical & Pharmaceutical Journal
