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目的探讨微卫星不稳定性对结肠癌术后FOLFOX方案辅助治疗的预后价值。方法 135例结肠癌术后行FOLFOX方案辅助治疗的患者作为研究对象,免疫组化方法检测肿瘤组织中修复DNA复制错误的错配修复蛋白表达,包括MLH1、MSH2、MSH6及PMS2蛋白的表达,分析微卫星不稳定性与患者临床特征及预后的相关性。结果微卫星不稳定性与患者肿瘤直径(χ~2=9.727,P<0.05)、淋巴转移(χ~2=13.172,P<0.05)、TNM分期(χ~2=11.867,P<0.05)及肿瘤部位(χ~2=5.224,P<0.05)有关,与年龄(χ~2=0.010,P>0.05)和性别(χ~2=0.953,P>0.05)无关。微卫星不稳定性患者的总生存期为(31.96±9.39)个月,优于微卫星稳定性患者的(21.27±11.45)个月,差异具有统计学意义(t=5.896,P<0.05)。微卫星不稳定性患者的无疾病生存期为(23.61±8.63)个月,微卫星稳定性患者的(14.51±10.41)个月,差异具有统计学意义(t=5.489,P<0.05)。多重变量分析表明,微卫星不稳定性是患者总生存期[HR=2.383,95%CI=(1.262,4.503),P=0.003<0.05]和无疾病生存期[HR=2.356,95%CI=(1.370,4.049),P=0.003<0.05]的独立预后因素。结论微卫星不稳定性是结肠癌术后FOLFOX方案辅助治疗患者的独立预后因素。
Objective To investigate the prognostic value of microsatellite instability in the adjuvant treatment of FOLFOX after colon cancer surgery. Methods A total of 135 patients with postoperative colon cancer undergoing FOLFOX regimen were enrolled in this study. Immunohistochemistry was used to detect mismatch repair protein expression in tumor tissues, including MLH1, MSH2, MSH6 and PMS2 protein. Relationship between microsatellite instability and clinical characteristics and prognosis of patients. Results Microsatellite instability was correlated with tumor diameter (χ ~ 2 = 9.727, P <0.05), lymph node metastasis (χ ~ 2 = 13.172, Tumor location (χ ~ 2 = 5.224, P <0.05), but not with age (χ ~ 2 = 0.010, P> 0.05) and sex (χ ~ 2 = 0.953, P> 0.05). The overall survival of patients with microsatellite instability was (31.96 ± 9.39) months, which was better than that of patients with microsatellite instability (21.27 ± 11.45) months. The difference was statistically significant (t = 5.896, P <0.05). The disease-free survival rate was (23.61 ± 8.63) months in microsatellite instability patients and (14.51 ± 10.41) months in microsatellite stable patients, the difference was statistically significant (t = 5.489, P <0.05). Multivariate analysis showed that microsatellite instability was the overall survival of patients [HR = 2.383, 95% CI = (1.262, 4.503), P = 0.003 <0.05] and disease free survival [HR = 2.356, 95% CI = (1.370, 4.049), P = 0.003 <0.05]. Conclusion Microsatellite instability is an independent prognostic factor for postoperative FOLFOX regimen in patients with colon cancer.