摘要
目的探究错配修复缺陷(Mismatch repair defects,dMMR)和肝细胞生长因子(Hepatocyte growth factor,HGF)在结直肠癌发病机制中的作用及其对患者预后的影响。方法选取2014年3月—2015年3月我院收治的72例结直肠癌患者(年龄≤45岁),应用免疫组化法检测dMMR和HGF表达情况,比较分析其预后情况。结果pMMR52例,dMMR20例,dMMR发生率为27.78%,其和肿瘤分化程度有关,但是和淋巴结转移、TNM分期、年龄、性别等无关。HGF阴性21例,阳性51例,因此HGF阳性率为70.83%。主要在间质成纤维和肿瘤细胞的细胞膜和细胞质上定位HGF蛋白。其表达和肿瘤发生部位、分化程度、年龄、性别、TNM分期无关,对比差异无统计学意义(P>0.05),但是HGF表达和dMMR现象间存在相关性。pMMR组的术后1年生存率为98.4%、术后3年为84.7%、术后5年为57.69%,dMMR组的术后1年生存率为90.5%、术后3年为56.2%、术后5年为35.00%,对比差异有统计学意义(P<0.05)。HGF阴性组术后1年生存率为100.00%、术后3年92.8%、术后5年66.67%,HGF阳性组术后1年生存率为94.2%、术后3年为68.5%、术后5年为47.06%,对比差异有统计学意义(P<0.05)。经单因素分析显示,患者的预后和TNM分期、dMMR、HGF表达,以及淋巴结转移情况有关。影响患者预后的独立因素,包含TNM分期、淋巴结转移情况、dMMR、HGF表达情况,对比差异有统计学意义(P<0.05)。结论针对结直肠癌患者,发现dMMR和HGF高表达是影响其预后独立因素,dMMR患者中有更高的HGF阳性率,安全有效,加快患者康复速度,具有临床应用价值。
Objective To explore the role of mismatch repair defect and hepatocyte growth factor in the pathogenesis of colorectal cancer and its impact on the prognosis of patients.Methods From March 2014 to March 2015,72 patients with colorectal cancer(age≤45 years old),using immunohistochemistry to detect dMMR and HGF expression,the prognosis was compared and analyzed.Results pMMR 52 cases,dMMR 20 cases,the incidence of dMMR was 27.78%,which was related to the degree of tumor differentiation,but not to lymph node metastasis,TNM stage,age,gender and so on.HGF was negative in 21 cases and positive in 51 cases(70.83%).HGF protein was mainly located on the cell membrane and cytoplasm of interstitial fibroblasts and tumor cells.There was no significant difference between the expression and tumor location,differentiation degree,age,gender and TNM stage(P>0.05),however,there was a correlation between HGF expression and dmmr phenomenon.The 1-year,3-year and 5-year survival rates in the pMMR group were 98.4%,84.7%and 57.69%,respectively,and in the dMMR group were 90.5%,56.2%and 35.00%respectively,with significant difference(P<0.05).The 1-year survival rate of HGF negative group was 100.00%,92.8%at 3 years and 66.67%at 5 years,and HGF posituve group was 94.2%,68.5%and 47.06%,respectively,with significant difference(P<0.05).Univariate analysis showed that the prognosis was related to TNM stage,expression of dmmr,HGF and lymph node metastasis.The independent factors affecting the prognosis of patients,including TNM stage,lymph node metastasis,dmmr,HGF expression,the difference was statistically significant(P<0.05).Conclusion For colorectal cancer patients,it is found that high expression of dMMR and HGF is an independent factor affecting their prognosis.dMMR patients have a higher positive rate of HGF,safe and effective,speed up the recovery of patients,and have clinical application value.
作者
林建光
陈平
康艺苹
许天文
LIN Jianguang;CHEN Ping;KANG Yiping;XU Tianwen(Department of Oncology,Second Affiliated Hospital of Fujian Medical University,Quanzhou Fujian 362000,China)
出处
《中国卫生标准管理》
2020年第24期49-53,共5页
China Health Standard Management
基金
泉州市科技计划项目(2018Z099)
泉州市科技计划项目(2018C051R)。
关键词
结直肠癌
发病机制
肝细胞生长因子
错配修复缺陷
预后
阳性率
colorectal cancer
pathogenesis
hepatocyte growth factor
mismatch repair deficiency
prognosis
positive rate
