结直肠癌中错配修复蛋白MLH1、PMS2、MSH2、MSH6和Ki-67表达的意义及与预后的关系

目的 探讨错配修复蛋白MLH1、PMS2、MSH2、MSH6和Ki-67的表达在结直肠癌（colorectal cancer, CRC）中的临床意义及与患者预后的相关性分析。方法选取213例符合纳入标准的结直肠癌患者,回顾性分析4种错配修复蛋白和Ki-67的表达在结直肠癌中的临床意义，分析其与随访患者预后的关系。结果在213例病例中， MLH1、PMS2的表达与结直肠癌的病变部位有关（P<0.05)，Ki-67的表达与结直肠癌的病变部位、脉管内癌栓侵犯有关（P<0.05），在男性、未侵及固有肌层、肿瘤分期为Ⅰ期的结直肠癌，4种错配修复蛋白MLH1、PMS2、MSH2、MSH6和Ki-67的表达有相关性（P<0.05），对符合标准的患者定期随访，微卫星不稳定性、Ki-67的表达与患者的无疾病进展生存率有相关性（P<0.05）。结论错配修复蛋白MLH1、PMS2、MSH2、MSH6和Ki-67的表达在结直肠癌的诊断、治疗及预后评估有一定的指导意义；且在一定情况下，错配修复蛋白MLH1、PMS2、MSH2、MSH6与Ki-67的表达存在相关性。

Clinical significance and prognostic correlation analysis of the expression of mismatch repair proteins MLH1, PMS2, MSH2, MSH6 and Ki-67 in colorectal cancer

Objective To investigate the clinical significance of the expression of mismatch repair proteins MLH1, PMS2, MSH2, MSH6 and Ki-67 in colorectal cancer (CRC)and their correlation with the prognosis. Methods Two hundred and thirteen colorectal cancer patients who met the inclusion criteria were selected to retrospectively analyze the clinical significance of the expression of four kinds of mismatch repair proteins and Ki-67 in colorectal cancer; and so weretheir correlationswith prognosis. Results In 213 cases who met the inclusion criteria, MLH1 and PMS2 were correlated to the lesion site of colorectal cancer; Ki-67 expression was correlated to the lesion site of colorectal cancer and invasion of tumor thrombus in vessels (P<0.05). The expression of MLH1, PMS2, MSH2, MSH6 and Ki-67 were significantly correlated in colorectal cancer of male sex, non-invasion of intrinsic muscle layer and tumor Stage Ⅰ(P<0.05). Microsatellite instability and Ki-67 expression were significantly correlated with disease progression free survival (P<0.05). Conclusion The expression of mismatch repair proteins MLH1, PMS2, MSH2, MSH6 and Ki-67 has certain guiding significance in the diagnosis, treatment and prognosis evaluation of colorectal cancer. In addition, under certain circumstances, the expression of mismatch repair proteins MLH1, PMS2, MSH2, and MSH6 is correlated with Ki-67, that is, the combined detection of mismatch repair proteins and Ki-67 can improve the accuracy of colorectal cancer diagnosis and prognosis evaluation.