冯莉, 韩晶, 吕雅蕾, 王玉栋, 荆丽, 王龙, 刘巍. hMLH1 hMSH2蛋白缺失与直肠癌临床病理特征预后的相关性研究[J]. 中国肿瘤临床, 2012, 39(22): 1800-1804. DOI: 10.3969/j.issn.1000-8179.2012.22.027
引用本文: 冯莉, 韩晶, 吕雅蕾, 王玉栋, 荆丽, 王龙, 刘巍. hMLH1 hMSH2蛋白缺失与直肠癌临床病理特征预后的相关性研究[J]. 中国肿瘤临床, 2012, 39(22): 1800-1804. DOI: 10.3969/j.issn.1000-8179.2012.22.027
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Li FENG, Jing HAN, Yalei Lǔ, Yudong WANG, Li JING, Long WANG, Wei LIU. Analysis of the Relationship of the Expression Deletion of hMLH1 and hMSH2 Proteins with the Clinico-pathologic Features and Prognosis of Rectal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(22): 1800-1804. DOI: 10.3969/j.issn.1000-8179.2012.22.027
Citation: Li FENG, Jing HAN, Yalei Lǔ, Yudong WANG, Li JING, Long WANG, Wei LIU. Analysis of the Relationship of the Expression Deletion of hMLH1 and hMSH2 Proteins with the Clinico-pathologic Features and Prognosis of Rectal Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(22): 1800-1804. DOI: 10.3969/j.issn.1000-8179.2012.22.027
shu

hMLH1 hMSH2蛋白缺失与直肠癌临床病理特征预后的相关性研究

Analysis of the Relationship of the Expression Deletion of hMLH1 and hMSH2 Proteins with the Clinico-pathologic Features and Prognosis of Rectal Cancer

    摘要
  • 摘要:
      目的   探讨hMLH1、hMSH2蛋白缺失与Ⅱ、Ⅲ期直肠癌患者临床病理特征及预后的相关性。
      方法  选取91例行直肠癌根治术且病理诊断明确的患者，采用免疫组织化学法检测患者hMLH1、hMSH2蛋白表达情况，采用χ2检验分析hMLH1、hMSH2蛋白表达缺失与直肠癌临床病理特征之间的关系；采用Kaplan-Meier生存曲线、Log-Rank检验、Cox风险回归模型分析不同因素与预后的关系。
      结果  hMLH1蛋白表达缺失率为30.77%，hMSH2蛋白表达缺失率为19.78%；hMLH1和（或）hMSH2蛋白缺失的患者与hMLH1、hMSH2蛋白表达无缺失的患者相比，在性别、年龄、病理类型、浸润深度、淋巴结转移、TNM分期6个方面临床病理特征差异无统计学意义（P均>0.05）；单因素及多因素分析显示hMLH1和（或）hMSH2蛋白情况及淋巴结转移数目为直肠癌患者预后的影响因素（P=0.010，P=0.032），且为独立影响因素（P=0.026，P=0.035）；hMLH1和（或）hMSH2蛋白缺失的患者2年无病生存率较hMLH1、hMSH2蛋白无缺失的患者明显提高（P=0.036）。
      结论  hMLH1、hMSH2蛋白缺失的直肠癌患者与hMLH1、hMSH2蛋白无缺失的患者具备相似的临床病理特征，但hMLH1、hMSH2蛋白缺失的患者预后较好。

     

    Abstract:
      Objective   This study discusses the relationship between the expression deletion of hMLH1 and hMSH2 proteins as well as the clinico-pathologic features or prognosis in patients with stages Ⅱ and Ⅲ rectal cancers.
      Methods  Ninety-one stages Ⅱ and Ⅲ rectal cancer patients, who obtained clear pathological diagnosis and underwent radical surgery, participated in this study. The hMLH1 and hMSH2 protein expressions were assessed by standard streptavidin-peroxidase immunohistochemistry. Chi-square test was used to analyze the relationship between the expression deletion of hMLH1 and hMSH2 proteins and clinico-pathologic features of the patients. Kaplan-Meier survival curves, log-rank test, and Cox proportional hazard model were employed to analyze the relationship among various factors and the prognosis.
      Results  The miss rates of the hMLH1 and hMSH2 protein expressions were 30.77% and 19.78%, respectively. No significant difference was found between the patients with and without the expression deletion of the hMLH1 and hMSH2 proteins with regard to their gender, age, pathological type, depth of infiltration, and number and stage of the lymph-node metastasis (P=0.751, 0.297, 0.829, 0.954, 0.132, and 0.300). Univariate and multivariate analyses suggested that disease-free survival (DFS) is affected by factors such as the number of nodal metastasis, as well as the status of the hMLH1 and/or hMSH2 protein expressions (P=0.010, 0.032). These are also the independent factors of DFS (P=0.026, P=0.035). Patients who presented expression deletion of hMLH1 and hMSH2 proteins have a much higher 2-year DFS rate compared with those who did not (P=0.036).
      Conclusion  Patients who present expression deletion of hMLH1 and hMSH2 proteins possess similar clinico-pathologic features with those expressing hMLH1 and hMSH2 proteins. However, the prognosis for the former is significantly favorable than for the latter.

     

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