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目的探讨错配修复(MMR)基因hMLH1和hMSH2的蛋白表达与遗传性非息肉病性结直肠癌(HNPCC)临床病理特征及预后的关系。方法应用免疫组化方法(Elivision-两步法)检测48例符合修订后的《Bethesda指南》的HNPCC患者中hMLH1和hMSH2蛋白的表达情况,并定义两者同时表达阳性为MMR蛋白表达,分析其表达与HNPCC临床病理特征及预后的关系。结果 hMLH1蛋白的表达缺失率为20.83(10/48),高于hMSH2蛋白的表达缺失率(8.33%,4/48),Ρ<0.05;MMR蛋白的表达阳性率为70.83%(34/48)。MMR蛋白表达与肿瘤的浸润深度相关(Ρ<0.05)。MMR蛋白表达缺失与表达正常者的总生存率分别为85.71%(12/14)和85.29%(29/34),两者生存曲线比较差异无统计学意义(Ρ>0.05)。结论 hMLH1蛋白的表达缺失率高于hMSH2蛋白,hMLH1和hMSH2蛋白表达缺失与肿瘤的浸润深度相关,与患者的预后无关。
Objective To investigate the relationship between the protein expression of hMLH1 and hMSH2 and the clinicopathological features and prognosis of hereditary nonpolyposis colorectal cancer (HNPCC). Methods The expression of hMLH1 and hMSH2 protein in 48 HNPCC patients with the revised “Bethesda Guidelines” was detected by immunohistochemistry (Elivision-two-step method), and the expression of both of them was defined as the expression of MMR protein Relationship between HNPCC Expression and Clinicopathological Characteristics and Prognosis. Results The deletion rate of hMLH1 protein was 20.83 (10/48), higher than that of hMSH2 protein deletion (8.33%, 4/48), P <0.05. The positive rate of MMR protein expression was 70.83% (34/48) . MMR protein expression was correlated with tumor invasion depth (P <0.05). The overall survival rates were 85.71% (12/14) and 85.29% (29/34), respectively. There was no significant difference in survival curves between the two groups (P> 0.05). Conclusion The loss of hMLH1 protein expression is higher than that of hMSH2 protein. The loss of hMLH1 and hMSH2 protein expression is related to the depth of tumor invasion, and has no relation with the prognosis of patients.