Analysis of the relationship of DNA mismatch repair with clinicopathologic features and prognosis of colon cancer
10.3760/cma.j.issn.0253-3766.2015.08.006
- VernacularTitle:DNA错配修复状态与结肠癌患者临床病理特征及预后的相关性
- Author:
Qiong QIN
1
,
2
;
Jianming YING
;
Ning LYU
;
Lei GUO
;
Wenxue ZHI
;
Aiping ZHOU
;
Jinwan WANG
Author Information
1. 100021中国医学科学院北京协和医学院肿瘤医院内科
2. 300052天津医科大学总医院肿瘤科
- Keywords:
Colonic neoplasms;
DNA mismatch repair;
Prognosis
- From:
Chinese Journal of Oncology
2015;(8):591-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between DNA mismatch repair ( MMR ) and clinicopathologic features and prognosis in patients with stages Ⅱ and Ⅲ colon cancers. Methods The clinical and pathological data of 440 patients with stage Ⅱ/Ⅲ colon cancer after radical resection were retrospectively reviewed and analyzed. Immunohistochemical staining was used to assess the expression of MMR proteins ( MLH1, MSH2, MSH6 and PMS2 ) , and the correlation between DNA MMR and clinicopathological features and prognosis of colon cancers was analyzed. Results Of the 440 tumor samples tested for DNA mismatch repair status, 90 (20.5%) demonstrated defective DNA mismatch repair and 350 (79.5%) had proficient DNA mismatch repair. Defective DNA mismatch repair ( dMMR) was associated with young patients (≤60), proximal colon cancer, stage Ⅱ, poorly differentiated adenocarcinoma and mucinous adenocarcinoma (P<0.05 for all). Among the 440 patients, 126 (28.6%) cases had recurrence or metastasis and 93 ( 21. 1%) died during the median follow?up of 61. 0 months. The five?year disease?free survival (DFS) rate was 82.2% among the patients with tumor exhibiting dMMR, significantly higher than that in patients with tumors exhibiting pMMR (68.9%, P=0.02). The univariate and mutlivariate analyses showed that the MMR status is an independent factor affecting 5?year disease?free survival and overall survival(OS) in colon cancer patients (P<0.05 for both). Conclusions Defective DNA mismatch repair ( dMMR) is associated with patients with proximal colon cancer, stage Ⅱ and poorly defferentiated adenocarcinoma and mucinous adenocarcinoma. The prognosis for patients with dMMR is better than those with pMMR. dMMR may be a useful biomarker for the prognosis of colon cancer.
