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目的 探讨错配修复(mismatch repair, MMR)基因表达差异同结直肠癌(colorectal cancer, CRC)患者病理特征的关系及其临床意义。方法 选取2021年1月～2024年9月在潍坊市中医院就诊并符合纳入标准的结直肠癌患者共103例，免疫组织化学检测MMR基因MLH1、MSH2、MSH6、PMS2的蛋白表达变化，依据Logistic回归分析构建了错配修复缺陷(mismatch repair deficiency, dMMR)结直肠癌患者影响因素的预测模型，采用Kaplan-Meier法进行生存分析，采用Log rank检验以及Cox多因素回归模型进行预后影响因素分析。结果 103例CRC患者dMMR的发生率为14.6%,二元Logistic回归结果显示，MMR状态与CRC患者的病理分期、淋巴结转移、肿瘤直径以及分化程度显著相关(P<0.05);103例患者3年无病生存率约为78.26%,两组患者生存率比较，差异有统计学意义(Log-Rank检验：χ2=3.875,P=0.0484),全组单因素分析显示，侵犯深度(χ2=4.090,P=0.043)、淋巴结转移(χ2=4.377,P=0.036)与患者的生存预后具有关联性。多因素Cox回归分析结果显示，淋巴结转移(HR=0.457,95%CI:0.214～0.979,P=0.044)是影响CRC患者预后的危险因素。结论 dMMR患者预后较差，淋巴结转移与患者的预后分期相关。
Abstract：Objective To analyze the pathological characteristics of colorectal cancer(CRC) patients based on differential MMR gene expression and its clinical significance.Methods A total of 103 patients with colorectal cancer who met the inclusion criteria and were treated at the Weifang Traditional Chinese Medicine Hospital from January 2021 to September 2024 were selected.Immunohistochemical detection of the protein expression changes of MMR genes MLH1,MSH2,MSH6,and PMS2 was performed.A predictive model for factors affecting mismatch repair deficiency(dMMR) in colorectal cancer patients was constructed based on Logistic regression analysis.Survival analysis was conducted using the Kaplan-Meier method, and prognostic factor analysis was carried out using the Log rank test and Cox multivariate regression model.Results The incidence of dMMR in 103 CRC patients was 14.6%.The binary logistic regression analysis showed that MMR status was significantly correlated with pathological stage, lymph node metastasis, tumor diameter and differentiation degree in CRC patients(P<0.05).The 3-year disease-free survival rate of 103 patients was about 78.26%,and the difference in survival rate between the two groups was statistically significant(Log-Rank test: χ2=3.875,P=0.0484).Univariate analysis showed that the depth of invasion(χ2=4.090,P=0.043) and lymph node metastasis(χ2=4.377,P=0.036) were correlated with the survival prognosis of patients.Multivariate Cox regression analysis showed that lymph node metastasis(HR=0.457,95%CI:0.214～0.979,P=0.044) was a risk factor for the prognosis of CRC patients.Conclusion dMMR patients have a poorer prognosis, and lymph node metastasis is correlated with the staging of the patient's prognosis.
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基本信息:
DOI：10.16846/j.issn.1004-3101.2025.06.003
中图分类号:R735.34
引用信息:
[1]孙婧瑜,王若曦,邸大琳,等.基于MMR基因表达差异的结直肠癌患者病理特征分析及其临床意义[J].山东第二医科大学学报,2025,47(06):418-423.DOI:10.16846/j.issn.1004-3101.2025.06.003.
基金信息:
山东省卫生健康委员会科研项目(项目编号：2019WS589)
2025-12-15
2025-12-15