错配修复基因联合中性粒细胞/淋巴细胞比值预测结肠癌术后复发的价值

目的 探讨不同错配修复基因（MMR）状态结肠癌临床病理特征，进一步评估MMR联合术前血中性粒细胞/淋巴细胞比值（NLR）用于预测结肠癌术后复发的价值。方法 回顾性分析125例结肠癌根治术后MMR免疫组织化学结果，分为错配修复缺陷组（dMMR）（55例），错配修复基因正常组（pMMR）（70例），并按MMR状态和NLR高低分为四组。结果 相比pMMR组，dMMR组结肠癌患者发病年龄较低，肿瘤体积大，分化程度低，多发于右半结肠，更多见神经侵犯（P<0.05）；ROC曲线确定NLR界值为3，dMMR组中低NLR值比例明显高于pMMR组（P<0.05）；按MMR状态和NLR高低分为四组后，dMMR并低NLR组3年无复发生存率为85.0%，明显高于其他三组（P<0.05）；生存分析显示与pMMR并高NLR组比较， dMMR并低NLR组存在显著的术后生存优势。结论 dMMR结肠癌具有独特的临床病理特征，MMR状态联合NLR值可用于评估结肠癌患者术后复发风险。

Value of Mismatch Repair Genes Combined with Neutrophil-Lymphocyte Ratio in Predicting Postoperative Recurrence of Colon Cancer

Objective To investigate the clinicopathological characteristics of colon cancer patients with different mismatch repair gene(MMR)status and evaluate the value of MMR status combined with preoperative blood neutrophil-lymphocyte ratio(NLR)in predicting postoperative recurrence of colon cancer.Methods We retrospectively analyzed the pathological MMR immunohistochemistry results of 125 colon cancer patients after radical resection.Patients were divided into deficient mismatch repair(dMMR)group(n=55)and proficient mismatch repair(pMMR)group(n=70),and further divided into four groups according to MMR status and NLR level.Results Compared with the pMMR group,the patients in the dMMR group had younger onset age,larger tumor size,lower differentiation and more nerve invasion,and were more likely to occur in the right hemicolon(P<0.05).According to the ROC curve,the NLR threshold was determined as 3.The proportion of low NLR in dMMR group was significantly higher than that in pMMR group(P<0.05).The 3-year recurrence-free survival rate of the dMMR with low NLR group was 85.0%,significantly higher than those of the other three groups(P<0.05);Survival analysis showed a significant advantage of the dMMR with low NLR group comparing with the pMMR with high NLR group.Conclusion dMMR colon cancer has unique clinicopathological characteristics.MMR status combined with NLR value can be used to evaluate the postoperative recurrence risk of colon cancer patients.