摘要
【目的】探讨微卫星不稳定性(MSI)及BRAF V600E基因突变与中晚期结直肠癌(CRC)临床病理特征及预后的相关性。【方法】选取2014年5月至2015年5月本院收治的行CRC根治术患者82例,收集患者的临床资料以及手术切除标本,对所有患者随访3年,记录患者的生存状况。分析MSI状态、BRAF V600E突变与患者临床病理特征的关系及对CRC患者预后的影响。【结果】高度微卫星不稳定(MSI-H)患者中淋巴结未转移比例较大、组织中低分化比例较高、BRAF V600E突变的比例较大且好发于右半结肠;BRAF V600E突变型患者与BRAF V600E野生型患者相比,组织高分化比例较大;BRAF V600E突变患者的无疾病生存率显著低于BRAF V600E野生型患者;微卫星稳定(MSS)患者中,BRAF V600E突变患者的无疾病生存率显著低于BRAF V600E野生型患者,BRAF V600E突变是影响CRC患者尤其是MSS患者预后的独立危险因素。【结论】MSI联合BRAF V600E突变监测可有效预测CRC患者预后。
【Objective】To investigate the relationship of microsatellite instability (MSI) and BRAF V600E mutation with clinicopathological features and prognosis of patients with advanced stages of colorectal cancer (CRC).【Methods】A total of 82 patients with radical resection of colorectal cancer admitted to our hospital from May 2014 to May 2015 were enrolled.The clinical data and surgical resection specimens of patients were collected.All patients were followed up for 3 years and the survival status of the patients was recorded.The relationship among MSI,BRAF V600E mutation and clinicopathological features were analyzed and compared.Furthermore the correlation of the value of BRAF V600E mutation in different microsatellite stable (MSS) subgroups with the prognosis of CRC patients was investigated as well.【Results】Lymph node metastasis (N1) was more frequently observed in MSI-H patients,poorly differentiated tissues,BRAF V600E mutation and right-sided tumors were in a larger proportion in MSI-H patients.Compared to BRAF V600E wild type patients,the BRAF V600E mutant patients had a higher proportion of poorly differentiated cancer and lower disease-free survival rate.In the MSS group,the disease-free survival rate of patients with BRAF V600E mutation was significantly lower than that of BRAF V600E wild type patients.So BRAF V600E mutation was an independent risk factor for the prognosis of patients with CRC,especially MSS.【Conclusion】Combining the detection of microsatellite instability and BRAF V600E mutation can effectively predict the prognosis of colorectal cancer patients.
作者
何兴状
杨正斌
牟辉
HE Xing-zhuang;YANG Zheng-bing;MOU Hui(Department of Pathology,First People's Hospital of Guangyuan City,Guangyuan Sichuan 628000,China)
出处
《医学临床研究》
CAS
2019年第8期1507-1509,共3页
Journal of Clinical Research
