ClinicalimpactofmicrosatelliteinstabilityincoloncancerfollowingadjuvantFOLFOXtherapy.docVIP

中国普外基础与临床杂志 普外科学新知栏目 电子版供稿单 题目 Title 来源 Resources Cancer Chemother Pharmacol.2010;66 4 :659-67. 原文发布日期 Date 24/12/2009 供稿内容 Contents 由于对出现MMR缺陷的大肠癌的研究在临床和病理学两方面都有重大意义,且目前对于将p53作为大肠癌预测标志并没有达成共识，Kim ST等人讨论了对于MSI-H/MMR-D和p53在oxaliplatin/5-FU/leucovorin,FOLFOX辅助疗法的进行R0切除结肠癌患者中的临床应用。他们分析了135个都在进行R0后接受了含5-FU和奥沙利铂的辅助化疗的病人样本。结果显示在接受FOLFOX辅助化疗的患者中MMR状况和DFSP 0.56）或OSP 0.61）没有明显关系。p53状况对DFS（P 0.11）和OS（P 0.94）也无明显影响。对于基因分型和IHC检测结果一致的患者（样本容量108），其样本的DFS（P 0.57）和OS（P 0.98）与MSI-H/MMR-D型以及MSI-L/S/MMR-I型肿瘤并无差异。他们的结论是MMR状况或p53阳性状况与患者接受FOLFOX辅助化疗的后果并无明显关联。在辅助化疗中加入奥沙利铂可能克服5-FU对于MSI-H/MMR-D型癌症的不良效应。 Title Clinical impact of microsatellite instability in colon cancer following adjuvant FOLFOX therapy 原文摘要 Abstract 全文请以PDF格式打包发送 PURPOSE: Colon cancer with DNA mismatch repair MMR defects reveals indistinguishable clinical and pathologic aspects, including better prognosis and reduced response to 5-fluorouracil 5-FU -based chemotherapy. There has been no consensus for p53 as a prognostic marker in colorectal cancer. This study investigated the clinical implication of MSI-H/MMR-D and p53 expression in R0-resected colon cancer patients who received adjuvant oxaliplatin/5-FU/leucovorin FOLFOX therapy. EXPERIMENTAL DESIGN: We analyzed 135 patients, who had been treated by adjuvant chemotherapy containing 5-FU and oxaliplatin FOLFOX after curative resection R0 for colon adenocarcinoma between May 2004 and November 2007. Tumor expression of the MMR proteins, MLH1 and MSH2, was detected by immunohistochemistry IHC in surgically resected tumor specimens. MSI was analyzed by polymerase chain reaction PCR amplification using fluorescent dye-labeled primers specific for microsatellite loci. Tumors with MMR defects were defined as those demonstrating loss of MMR protein expression MMR-D and/or microsatellite instability high MSI-H genotype. Expression patterns of p53 were determined in a semiquantitative manner by light microscopy. RESULTS: There were 13 9.6% patients with sta