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1.
Rev. Assoc. Med. Bras. (1992) ; 67(1): 64-70, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287776

ABSTRACT

SUMMARY OBJECTIVE: Bladder cancer under the age of 40 is extremely rare. Bladder cancer development involves complex and multi-stage processes, one of which is the DNA damage repair mechanism. In this retrospective study, we aimed to evaluate the histopathological features of bladder urothelial carcinoma seen in patients under 40 years of age and tumor microsatellite instability status using immunohistochemistry. METHODS: A total of 50 patients under the age of 40 with urothelial bladder carcinoma from two different centers in the same country were included. Expression of the mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 was analyzed by immunohistochemistry. RESULTS: Age at the time of diagnosis ranged from 17 to 40 years old. Most tumors were non-invasive papillary urothelial carcinoma. Two cases had nuclear loss of MSH-6 and PMS-2. We observed that tumor grade, tumor stage, presence of tumor differentiation, and infiltrative growth pattern of the tumor have significant impact on prognosis, but microsatellite instability does not have an effective role in bladder carcinogenesis in young patients. CONCLUSIONS: Our results indicate that the presence of microsatellite instability is not related to the low tumor grade and stage in urothelial neoplasms in young patients, suggesting that urothelial carcinoma of the bladder in young patients may represent a genetically stable form of neoplasia.


Subject(s)
Humans , Adolescent , Adult , Young Adult , Carcinoma, Transitional Cell/genetics , Microsatellite Instability , Urinary Bladder/metabolism , Retrospective Studies , DNA-Binding Proteins/genetics , DNA-Binding Proteins/metabolism , DNA Mismatch Repair
2.
Rev. colomb. cir ; 36(1): 120-131, 20210000. tab
Article in Spanish | LILACS | ID: biblio-1150526

ABSTRACT

La inestabilidad microsatelital es causada por una alteración de los sistemas de reparación de apareamiento incorrecto, que puede afectar los microsatélites dentro de todo el genoma humano, produciendo errores en su replicación. Los estudios publicados, principalmente en la literatura inglesa, han encontrado que algunos tumores, como los gástricos, pueden expresar inestabilidad microsatelital. En la siguiente revisión de tema, se presenta una descripción de los sistemas de reparación de apareamientos incorrectos y su relación con la presencia de inestabilidad microsatelital en los tumores gástricos, así como su posible utilidad clínica, como factor asociado en la respuesta al tratamiento con inmunoterapia en los pacientes con dicha patología


Microsatellite instability is caused by an alteration of the mismatch repair systems, which can affect microsatellites within the entire human genome, causing errors in their replication. Published studies, mainly in the English literature, have found that some tumors, such as gastric ones, can express microsatellite instability. In this review, a description of the mismatch repair systems and their relationship with the presence of microsatellite instability in gastric tumors is presented, as well as its possible clinical utility, as an associated factor in the response to immunotherapy treatment, in patients with gastric cancer


Subject(s)
Humans , Stomach Neoplasms , Microsatellite Instability , Immunotherapy , Neoplasms
3.
Article in Chinese | WPRIM | ID: wpr-910178

ABSTRACT

Objective:To explore the application and clinical significance of the cancer genome atlas (TCGA) molecular classification in endometrial cancer (EC).Methods:Sixty-six EC patients collected from December 2018 to March 2021 from Peking University People′s Hospital were categorized into four subgroups based on TCGA molecular classification tested by next generation sequencing. The correlation among four molecular subgroups and the clinical-pathological features including prognosis were analyzed.Results:(1) Clinical and pathological features: median age at diagnosis was 56 years (range: 24-78 years). The cases were distributed as follows: 3 (5%) cases DNA polymerase epsilon (POLE) ultra-mutated, 11 (17%) cases high microsatellite instability (MSI-H) including 2 Lynch syndrome, 42 (64%) cases low copy-number (CN-L) and 10 (15%) cases high copy-number (CN-H). There were significant differences among four subtypes in the combination of other tumors, tumor family history, surgical method, International Federation of Gynecology and Obstetrics (FIGO, 2009) stage, depth of muscle invasion and lymph vascular space invasion (all P<0.05). The proportions of patients in CN-H subgroup with advanced FIGO stage (stage Ⅲ-Ⅳ), deep muscle invasion and positive lymph-vascular space invasion were significantly increased. There were no significant differences in age, menopausal status, body mass index, metabolic syndrome-related complications, preoperative serum CA 125 and human epididymis protein 4 levels, tumor size, pathological grade (only endometrioid cancer), and lymph node metastasis among the 4 TCGA molecular types (all P>0.05). (2) Immuno-related molecular analysis: among 66 EC patients, 27 patients underwent immunohistochemical analysis of programmed cell death 1 ligand 1 (PD-L1) protein, and 28 patients underwent tumor mutation burden (TMB) detection. POLE and MSI-H subgroups contained TMB than those in CN-L and CN-H ( P<0.05).(3) Prognosis: the median follow-up time was 10 months (range: 0-28 months). The progression-free survival rate of TCGA molecular types were 100% (POLE ultra-mutated), 100% (MSI-H), 98% (CN-L), and 80% (CN-H) respectively and had significant differences ( P=0.034). The overall survival were 100% (POLE ultra-mutated), 100% (MSI-H), 98% (CN-L), and 90% (CN-H) respectively, but there were not statistically significant difference ( P=0.361). POLE ultra-mutated and MSI-H subgroups had the best survival, while CN-H had the worst. Conclusion:TCGA molecular classification has feasibility and clinical value in clinical application of EC, which is helpful to identify the prognosis of patients.

4.
International Journal of Surgery ; (12): 769-773,f4, 2021.
Article in Chinese | WPRIM | ID: wpr-907521

ABSTRACT

Objective:To explore the characteristics of Siewert classification and microsatellite instability(MSI) and HER2 expression in adenocarcinoma of esophagogastric junction (AEG).Methods:The clinicopathological data of gastric adenocarcinoma from May 2019 to November 2020 were retrospectively analyzed. The patients were divided into two groups: AEG group and non AEG group. The composition ratio of Siewert type of AEG was counted, and the relationship between tumor size and Siewert type was analyzed. The MSI status and HER2 expression status of AEG and non AEG were statistically compared. The measurement data of normal distribution were expressed as mean ± standard deviation( Mean± SD), the comparison between groups were by t test, the comparison of count data between groups were by Chi-square test. Results:A total of 328 consecutive cases of gastric adenocarcinoma were collected, including 242 cases of AEG and 86 cases of non AEG. The Siewert classification of AEG was mainly type Ⅱ (151 cases, 62.40%), followed by type Ⅲ (86 cases, 35.54%) and type Ⅰ (5 cases, 2.07%). The analysis of the relationship between the size of the tumor length and the number of Siewert type showed that the number of Siewert type Ⅱ cases decreased and the number of Siewert type Ⅲ cases increased with the increase of the tumor size. MSI status was detected non selectively in 192 cases of gastric adenocarcinoma (140 cases of AEG and 52 cases of non AEG). There were 12 cases of MSI (6.25%), 2 cases of MSI-H (1.04%) and 10 cases of MSI-L (5.21%). There was no significant difference in MSI ratio between AEG group and non AEG group ( P>0.05). All MSI cases were negative or weakly positive for PMS2. The expression of HER2 was detected by immunohistochemistry in 313 cases of gastric adenocarcinoma, except 15 cases of PTIS/T1a. There were 30 cases (9.58%) with HER2 expression 3+ . Thirty-two cases (10.22%) expressed HER2 (2+ ), of which 7 cases were detected by fluorescence in situ hybridization (FISH), and 3 cases were positive. The proportion of HER2 (3+ ) in AEG was significantly higher than that in non AEG group ( P<0.05). Conclusions:The main type of AEG was Siewert type Ⅱ. AEG may mostly occur between 1 cm above the esophagogastric junction and 2 cm below the esophagogastric junction; For endoscopic screening of early AEG, more attention should be paid to this area of stomach. Siewert type Ⅲ may be derived from the development of Siewert type Ⅱ. The incidence of microsatellite instability in gastric cancer is low. Compared with other gastric adenocarcinoma, AEG has no specificity in MSI. The MSI of AEG was mainly the expression defect of PMS2. Compared with other gastric adenocarcinoma, there are more HER2 overexpression in AEG.

5.
International Journal of Surgery ; (12): 565-571, 2021.
Article in Chinese | WPRIM | ID: wpr-907482

ABSTRACT

The programmed cell death receptor 1 (PD-1) antibody has been used in the treatment of a variety of malignant tumors, in which colorectal cancer is considered immune " cold" tumor and is not sensitive to anti-PD-1 therapy. The molecular characteristics of mismatch repair deficient (dMMR)/high microsatellite instability (MSI-H) are important molecular markers for screening patients with immune checkpoint inhibitors therapy (ICIs). However, only some patients can benefit from ICIs treatment, and some patients even have disease progression. This article summarizes the research progress of anti-PD-1 immunotherapy of MSI-CRC in recent years, including the mechanisms of resistance, new efficacy biomarkers and treatment options, so as to provide ideas for expanding the application of immunotherapy in colorectal cancer.

6.
Acta Pharmaceutica Sinica B ; (6): 2983-2994, 2021.
Article in English | WPRIM | ID: wpr-922779

ABSTRACT

Genomic instability remains an enabling feature of cancer and promotes malignant transformation. Alterations of DNA damage response (DDR) pathways allow genomic instability, generate neoantigens, upregulate the expression of programmed death ligand 1 (PD-L1) and interact with signaling such as cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling. Here, we review the basic knowledge of DDR pathways, mechanisms of genomic instability induced by DDR alterations, impacts of DDR alterations on immune system, and the potential applications of DDR alterations as biomarkers and therapeutic targets in cancer immunotherapy.

7.
Article in English | WPRIM | ID: wpr-880694

ABSTRACT

Lymphoma is one of the most common malignant tumor of the hematologic system. The genome instability is not only an important molecular basis for the development of lymphoma, but also has important value in the diagnosis and prognosis of lymphoma. There are 2 types of genome instability: Microsatellite instability (MSI/MIN) at gene level and chromosomal instability at chromosome level. Through the study on genes associated with lymphoma, the unstable genes associated with lymphoma could be found, meanwhile the mechanism of its occurrence and development of lymphoma could be explored, and the important basis of molecular biology could also be provided in the field of current hot lymphoma precision medical research.


Subject(s)
Genomic Instability , Humans , Lymphoma/genetics , Microsatellite Instability , Microsatellite Repeats , Neoplasms
8.
J. coloproctol. (Rio J., Impr.) ; 40(4): 412-420, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1143169

ABSTRACT

ABSTRACT Introduction: Colorectal cancer is the third most common cancer worldwide, with about 15% of these tumours related with microsatellite instability, which confers distinct characteristics to these tumours, both clinicopathological and in the response to treatments. In fact, the poor response to chemotherapy in these tumours has led to the investigation for new treatments, with immunotherapy being the most successful one to date. The focus of this review is to assess the response of microsatellite unstable colorectal cancer to PD-1 blockade, and the mechanisms behind that response. Methods: A PubMed research was conducted, resulting in the inclusion of 47 articles in this review. Results: Microsatellite instability results in a high neoantigen load, leading to a highly active immune microenvironment of the tumour, mainly due to T-cells. To counteract this, there is an upregulation of PD-1, acting as a "brake" for immune cells, facilitating tumour growth and metastasis. This upregulation makes these tumours great candidates for treatment with PD-1 blockade, as seen in many clinical trials, where the overall responses and progression free survival rates were higher than those observed in microsatellite stable tumours. Conclusion: With the importance of colorectal cancer with microsatellite instability new treatments are necessary. Therefore, PD-1 blockade is a promising treatment for colorectal cancer with microsatellite instability, with improvement in survival rates and a better prognosis for these patients.


RESUMO Introdução: O câncer colorretal é o terceiro mais comum em todo o mundo, com cerca de 15% desses tumores relacionados com instabilidade dos microssatélites, o que confere características distintas a esses tumores, tanto clínico patológicas quanto na resposta aos tratamentos. De fato, a fraca resposta à quimioterapia nesses tumores levou à investigação de novos tratamentos, sendo a imunoterapia a mais bem sucedida até o momento. O foco desta revisão é avaliar a resposta do câncer colorretal com microssatélites instáveis ao bloqueio do PD-1 e os mecanismos por trás dessa resposta. Métodos: Foi realizada uma pesquisa na base de dados PubMed, resultando na inclusão de 47 artigos nesta revisão. Resultados: A instabilidade de microssatélites resulta em uma alta carga de neoantígenos, levando a um microambiente imunológico altamente ativo do tumor, principalmente devido às células T. Para neutralizar isso, há uma maior expressão do PD-1, atuando como um "freio" para as células imunes, facilitando o crescimento do tumor e suas metástases. Essa expressão faz desses tumores grandes candidatos ao tratamento com bloqueio PD-1, como demonstrado em vários ensaios clínicos, onde as respostas globais e as taxas de sobrevivência livres de progressão foram maiores do que as observadas em tumores com microssatélites estáveis. Conclusão: Com a importância do câncer colorretal com instabilidade de microssatélites, novos tratamentos são necessários. Portanto, o bloqueio do PD-1 é um tratamento promissor para o câncer colorretal com instabilidade de microssatélites, com melhora nas taxas de sobrevivência e melhor prognóstico para esses pacientes.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/pathology , Programmed Cell Death 1 Receptor/therapeutic use , Immunotherapy/methods , Microsatellite Instability
9.
J. coloproctol. (Rio J., Impr.) ; 40(4): 404-411, Oct.-Dec. 2020.
Article in English | LILACS | ID: biblio-1143186

ABSTRACT

ABSTRACT Introduction: Colorectal cancer is one of the neoplasms with the greatest social impact. Given the great molecular heterogeneity and diversity of pathophysiological mechanisms, it is difficult to define prognostic factors that could guide therapy. Objectives: To identify the molecular prognostic factors that may be of interest in clinical practice and to synthesize the existing evidence. Material and methods: The search for the articles was carried out using the PubMed platform and the keywords "sporadic colorectal cancer and prognosis", for articles published between 2014 and 2019. We selected all articles published on studies in humans and written in English or Portuguese. Of the 215 articles found, 35 articles were selected to perform this review. Results: Current evidence supports the use of four molecular markers in clinical practice − KRAS, NRAS and BRAF (EGFR signalling pathway) and the mismatch repair status. Conclusion: The use of molecular biomarkers in clinical practice to define prognosis is still little supported by the existent evidence. The studies are slightly contradictory, so new projects and international collaborations must be carried out in this area to obtain more robust evidence.


RESUMO Introdução: O carcinoma colorretal é uma das neoplasias com maior impacto social. Dada a grande heterogeneidade molecular e diversidade de mecanismos fisiopatológicos, torna-se difícil definir fatores de prognóstico que orientem a terapêutica. Objetivos: Identificar os fatores de prognóstico moleculares que poderão vir a ter interesse na prática clínica e fazer uma síntese da evidência existente. Material e métodos: A pesquisa dos artigos foi realizada recorrendo à plataforma PubMed e utilizou-se as palavras-chave "sporadic colorectal cancer and prognosis", para artigos publicados entre 2014 e 2019. Foram selecionados todos os artigos publicados sobre estudos em humanos e escritos em inglês ou em português. Dos 215 artigos encontrados, foram selecionados 35 artigos para realizar esta revisão. Resultados: A evidência atual apoia a utilização de quatro marcadores moleculares na prática clínica - KRAS, NRAS e BRAF (via de sinalização do EGFR) e o estado mismatch repair. Conclusão: A utilização na prática clínica de biomarcadores moleculares para definir o prognóstico é ainda pouco apoiada pela evidência disponível. Os estudos são algo contraditórios, pelo que novos projetos e colaborações internacionais devem ser realizados neste âmbito para se obter evidência mais robusta.


Subject(s)
Humans , Carcinoma , Biomarkers , Colorectal Neoplasms/diagnosis , Chromosomal Instability , Microsatellite Instability , Prognosis
10.
Article | IMSEAR | ID: sea-210181

ABSTRACT

Introduction:In Uganda, the Kampala Cancer Registry has reported a steady increase in the incidence of colorectal carcinoma(CRC) over the last few decades. The author reports a case of a 25 year old gentlemanpresenting with bowel obstruction and found to have mucinous adenocarcinoma of the colon. This is followed by a literature review of the clinical and pathological characteristics of young age sporadic colorectal carcinoma (YSCC) and hereditary nonpolyposis colorectal carcinoma (HNPCC).Presentation of Case:This patient presented with a family history of colorectal carcinoma (CRC) and with bowel obstruction. An emergency laparotomy involving a right hemicolectomy was carried out. The postoperative course of this patient was uneventful. Discussion:The typical histological features of mucinous adenocarcinoma of the colon were seen on the resected colon specimen. In addition this study reviews the literature regarding the clinical presentation, pathological characteristics, histology and prognosis of mucinous and medullary carcinoma of the colon.Conclusions:Mucinous adenocarcinoma happens to be the most common histological type of colorectal carcinoma in young adults. In Uganda, low risk young patients withsymptoms should be screened for colorectal lesions. A high index of suspicion should therefore be taken in the diagnosis of colorectal malignancy in these patients

11.
Article in Chinese | WPRIM | ID: wpr-880786

ABSTRACT

OBJECTIVE@#To explore the clinicopathological features and types of genic mutations in DNA mismatch repair (MMR) in colorectal cancer (CRC).@*METHODS@#Immunohistochemistry was used to determine the expression of MMR proteins in 1394 patients with CRC, and PCR-capillary electrophoresis (PCR-CE) was used to detect microsatellite instability (MSI) in 106 cases of defective MMR (dMMR), 46 cases of proficient MMR (pMMR) with heterogeneous expression and 147 randomly selected cases of pMMR. The relationship between the expressions of MMR proteins and the clinicopathological features of the patients was evaluated. The consistency between the results of immunohistochemistry and PCR-CE was assessed.@*RESULTS@#Immunohistochemical staining showed an incidence of dMMR of 7.6% in the patients. The main type of dMMR was co-deletion of MLH1 and PMS2, accounting for 55.7% of the total dMMR cases. The deletion of MMR proteins was significantly correlated with the patients' age, tumor location, tumor size, gross type, histological type, degree of differentiation, lymph node status and TNM stage (@*CONCLUSIONS@#The main type of dMMR is co-deletion of MLH1 and PMS2 in patients with colorectal cancer. dMMR colorectal cancer has typical clinicopathological features and a lower incidence in China than in Western countries. The results of immunohistochemistry and PCR-CE are highly consistent for detecting dMMR in colorectal cancer patients.


Subject(s)
China , Colorectal Neoplasms/genetics , DNA Mismatch Repair/genetics , Humans , Microsatellite Instability
12.
Article in Chinese | WPRIM | ID: wpr-861733

ABSTRACT

Colorectal cancer (CRC) has a high morbidity and mortality rate worldwide. Current studies indicate that CRC is a heterogeneous disease caused by long-term accumulation and joint action of genetic instability caused by various reasons. Microsatellite instability (MSI) is one of the main pathways. This article reviewed the advances in research on correlation of MSI with CRC.

13.
Article in Chinese | WPRIM | ID: wpr-861727

ABSTRACT

Background: Studies have indicated that there are two main pathogenetic pathways of colorectal cancer, chromosomal instability pathway and microsatellite instability (MSI) pathway. Aims: To investigate the expressions and clinical significance of mismatch repair protein (MMRP) and p53 protein in colorectal cancer. Methods: Immunohistochemical SP staining was used to detect the expressions of 4 MMRP and p53 protein in 276 colorectal cancer patients from Jan. 2013 to Dec. 2017 at Jiading Central Hospital of Shanghai, and their relationships with clinicopathological features were analyzed. The influence of MSI on survival rate of patients with colorectal cancer was analyzed. Results: The deficit of expression rate of MMRP was 13.0%. MSI was associated with histological type, TNM staging, Schistosomiasis infection (P0.05). The positivity expression rate of p53 was 44.9%, and the expression was correlated with histological type, TNM staging, lymph node metastasis, Schistosomiasis infection (P0.05). MSI was negatively correlated with p53 expression (r=-0.169,P<0.05). The 1-, 3-, 5-year survival rates in MSI group and MSS group were 100%, 97.2%, 83.1% and 96.7%, 81.9%, 38.9%, respectively, and the difference was statistically significant (χ2=12.582, P=0.001). Conclusions: MSI and p53 are closely related to the clinicopathological features of colorectal cancer, and have some values in predicting the degree of malignancy and prognosis of colorectal cancer. MSI is negatively correlated with p53 expression, which indicates that the two may participate in different stages of development and progress of colorectal cancer.

14.
Article in Chinese | WPRIM | ID: wpr-861564

ABSTRACT

Objective: Here, we aimed to analyze the two most commonly used methods for screening DNA mismatch repair (MMR) gene deletions in colorectal cancer to establish a more cost-effective strategy. Methods: A total of 223 patients with colorectal cancer were recruited from the First Affiliated Hospital of Xinjiang Medical University for this study from September 2018 to September 2019. Using the Ventana BenchMark ULTRA automatic immunohistochemistry platform, the expression levels of MLH1, MSH2, PMS2, and MSH6 proteins were assessed, and the microsatellite instability (MSI) status of the tumors was then determined through PCR capillary electrophoresis. Results: Among the 223 patients with colorectal cancer, 27 (12.1%) had MMR deficiency (dMMR) and 196 (87.9%) had MMR proficiency (pMMR). The missing rates of MLH1, MSH2, MSH6, and PMS2 were estimated as 9.0% (20/223), 1.8% (4/223), 2.7% (6/223), and 9.4% (21/223), respectively. The sensitivity and specificity of the two-antibody test employing antibodies against only PMS2 and MSH6 for screening dMMR colorectal cancer were the same as those of the four-antibody test. Twenty-seven cases exhibited high microsatellite instability (MSI-H) (12.1%) and 196 cases exhibited microsatellite stability (MSS) (87.9%). However, no case exhibited low microsatellite stability (MSI-L). The sensitivities of BAT-25, BAT-26, NR-21, NR-24, NR-27, and MONO-27 were 88.9%, 92.6%, 96.3%, 70.4%, 92.6%, and 77.8%, respectively. When MSI was defined using three markers, NR-21, NR-27, and BAT-26, with at least one of the three exhibiting instability, the results were the same as those obtained using the six-marker group. Conclusions: The proposed two-marker detection strategy provides a simple, reliable, and low-cost method for the identification of dMMR/MSI in colorectal cancer.

15.
Chinese Journal of Oncology ; (12): 734-741, 2019.
Article in Chinese | WPRIM | ID: wpr-773350

ABSTRACT

Microsatellite instability (MSI) which resulted from the deficiency of DNA mismatch repair (MMR), is an important clinical significance in the related solid tumors, such as colorectal cancer and endometrial cancer. There are several methods to detect MSI status, including immunohistochemistry for MMR protein, multiplex fluorescent polymerase chain reaction (PCR) for microsatellite site and MSI algorithm based on next generation sequencing (NGS). The consensus elaborates the definition and clinical significance of MSI as well as the advantages and disadvantages of the three detection methods. Through this expert consensus, we hope to promote the screening which based on MSI status in malignant tumors and improve the acknowledge of clinicians about various testing methods. Thereby, they could interpret the results more accurately and provide better clinical services to patients.


Subject(s)
Antineoplastic Agents , Therapeutic Uses , China , Colorectal Neoplasms , Genetics , Pathology , Consensus , DNA Mismatch Repair , DNA Sequence, Unstable , Delivery of Health Care , Reference Standards , Endometrial Neoplasms , Female , Humans , Immunohistochemistry , Microsatellite Instability , Microsatellite Repeats , Microscopy, Fluorescence , Polymerase Chain Reaction , Practice Guidelines as Topic
16.
Article in Chinese | WPRIM | ID: wpr-810790

ABSTRACT

Lynch syndrome (LS), which is the most common hereditary colorectal cancer, accounts for about 3% of all colorectal cancers. However, due to its various clinical manifestations, it is difficult to be diagnosed. The diagnosis of LS requires comprehensive application of various screening criteria (such as the Amsterdam criteria, Bethesda criteria), predictive models, risk factors, immunohistochemistry test of mismatch repair (MMR) protein, microsatellite instability (MSI) detection, MLH1 methylation detection, BRAF gene mutation detection, germline gene mutation detection, and so on. LS can be diagnosed only after the identification of pathogenic germline mutation of MMR gene. The first-degree and second-degree relatives of LS patients are recommended to be tested for the identified mutant gene. For LS patients and gene mutation carriers, LS associated cancer can be detected early or even prevented by monitoring and preventive surgery. Reproductive techniques can be used to prevent this disease from being passed down to the next generation.

17.
Article in Chinese | WPRIM | ID: wpr-861889

ABSTRACT

Background: Colorectal cancer (CRC) is a commonly seen cancer, and is a heterogeneous disease entity with a diverse biological pathogenesis. Aims: To investigate the expressions of mismatch repair protein (MMRP) and Ki-67 in CRC, and analyze the correlations of microsatellite instability (MSI), Ki-67 with clinicopathological features of CRC. Methods: Clinicopathological data of 90 CRC patients from Jan. 2014 to Dec. 2016 at the First Affiliated Hospital of Soochow University were retrospectively analyzed. Immunohistochemical staining was used to detect the protein expressions of 4 MMRP (MLH1, PMS2, MSH2 and MSH6) and Ki-67 in CRC patients. Correlations of MSI, Ki-67 with clinicopathological features of CRC patients were analyzed. Correlation of MSI with Ki-67 was also analyzed. Results: The loss expression rate of MMRP was 16.7%, and that of MLH1, PMS2, MSH2 and MSH6 were 11.1%, 11.1%, 6.7% and 4.4%, respectively. Positivity rate of Ki-67 was 90.0%. MSI was correlated with tumor location (P0.05). Expression of MLH1 was positively correlated with expression of PMS2 (r=0.577, P<0.05), and expression of MSH2 was positively correlated with expression of MSH6 (r=0.739, P<0.05). Conclusions: The loss expressions of MLH1, PMS2 are more common than those of MSH2, MSH6 in CRC. MSI is correlated with tumor location and Ki-67 is correlated with tumor location and gross type; they may be of some significance for the diagnosis and prediction of prognosis of CRC. However, MSI is not correlated with Ki-67, and joint detection of MMRP and Ki-67 could not improve the diagnostic accuracy of CRC.

18.
Article in Chinese | WPRIM | ID: wpr-861801

ABSTRACT

Background: Colon cancer is one of the most common malignant tumor of digestive system. There are differences in pathogenesis, biological behavior, gene expression between left and right hemicolon cancer. Aims: To investigate the differences in clinicopathological features, microsatellite instability (MSI) and K-ras gene mutation between left and right hemicolon cancer. Methods: Data of 144 patients with colon cancer diagnosed by postoperative pathology from June 2017 to June 2018 at Qingdao Municipal Hospital were collected. MSI was assessed by immunohistochemistry, K-ras gene mutation was detected by PCR. The differences in clinicopathological features, MSI and K-ras gene mutation between the two groups were compared. Results: Right hemicolon cancer was more common in female, and left hemicolon cancer was more common in male. The incidence of lymph node metastasis, positivity rate of CEA and MSI in right hemicolon cancer were significantly higher than left hemicolon cancer (P<0.01), while the K-ras gene mutation rate in left hemicolon cancer was significantly higher than right hemicolon cancer (P<0.05). The K-ras gene mutation in left hemicolon cancer was correlated with gender, lymph node metastasis and positivity rate of CEA (P<0.05). MSI in right hemicolon cancer was correlated with gender, age, and lymph node metastasis (P<0.05). Conclusions: There are differences in the MSI and K-ras gene mutation between left hemicolon cancer and right hemicolon cancer, which can be used as the reference for diagnosis, individualized treatment and prognosis of colon cancer.

19.
Article in Chinese | WPRIM | ID: wpr-861175

ABSTRACT

Objective: To investigate the value of texture analysis of iodine-based material decomposition images with spectral CT imaging for predicting microsatellite instability (MSI) status in colorectal cancer (CRC). Methods: Data of 23 patients with MSI status CRC and 46 patients with microsatellite stability (MSS) status CRC confirmed by postoperative pathology were retrospectively analyzed. All CRC patients underwent preoperative abdominal gemstone spectral imaging. Iodine-based material decomposition images in arterial and venous phases were produced with Viewer software, and the images were imported into Omni-Kinetics software for ROI sketching and feature extraction. The texture parameters included minimum intensity, maximum intensity, mean intensity, median intensity, standard deviation, kewness, kurtosis, uniformity, energy and entropy. The differences of parameters between the two groups were compared. Logistic regression was used to combine texture parameters. Diagnostic performances of various texture parameters and the combination of multiple parameters were studied with ROC analysis. Results: Both in arterial and venous phases, the minimum, maximum, mean, median, and uniformity in MSI group were significantly lower than those in MSS group (all P0.05). In venous phase, entropy in MSI group was significantly higher than that in MSS group (t=1.81, P=0.04). In arterial phase, there was no significant difference in entropy between the two groups (t=0.22, P=0.80). ROC analysis showed that the range of AUC for predicting MSI status in CRC patients using single texture parameter as minimum, maximum, mean, median, uniformity in arterial and venous phase or entropy in venous phase was 0.64~0.82. Multi-parameter combined diagnosis Logistic regression model was -2.598-0.124×arterial phase minimum-0.039×arterial phase maximum-0.774×arterial phase median+1×arterial phase mean-1.892×arterial phase uniformity+0.14×venous phase minimum+0.2×venous phase maximum+0.343×venous phase median-0.61×venous phase mean+13.711×venous phase uniformity-2.598×venous phase entropy. When combined multiple texture parameters, the AUC was 0.83. Conclusion: Texture analysis of iodine-based material decomposition image with spectral CT can serve as a preoperative non-invasive method for predicting MSI status in CRC patients. And the optimal predictive value was observed when combined all significant texture parameters.

20.
Article in Chinese | WPRIM | ID: wpr-843948

ABSTRACT

Objective: To investigate the expressions of CD8, CD68, PD-1 and PD-L1 in microsatellite stability/instability (MSS/MSI) gastric cancer and the prognostic value of microsatellite stability. Methods: Sixty consecutive primary gastric cancer samples were collected from March 2012 to August 2012. The clinical pathological and survival information was collected as well. Immunohistochemistry of MLH1, MSH2, MSH6, PMS2, CD8, CD68, PD-1 and PD-L1 was conducted for each sample. The survival prognosis was analyzed by log-rank test. Results: There were 15 MSI gastric cancer samples (25.0%) with negative staining of MLH1, MSH2, MSH6 and PMS2. There was no significant difference in the expression of CD8, PD-1 or PD-L1 between MSS and MSI gastric cancer, but the CD68 positive macrophages infiltration was higher in MSS than in MSI gastric cancer (P=0.046). Type Ⅱ (CD8-PD-L1-) was the major immune type (46.67%) in MSI gastric cancer, and the main immune type of MSS gastric cancer was type Ⅱ (33.33%) and type (CD8+PD-L1-, 31.11%). The disease-free survival (P=0.036) and overall survival (P=0.041) in MSI gastric cancer was longer than in MSS. Conclusion: MSI gastric cancer predicts a better prognosis although the tumor microenvironment shows a lower immune response.

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