【摘要】 目的探讨错配修复缺陷结直肠癌的临床病理特征。方法调取2016年3月至2018年12月在我院手术后经病理确诊且错配修复缺陷(dMMR)的结直肠癌患者74例,随机选取同时期错配修复正常型(pMMR)结直肠癌患者148例作为对照,统计分析两组患者临床病理资料。结果 dMMR与pMMR结直肠癌患者的年龄、发病部位、分化程度、肿瘤大小之间存在显著差异:dMMR型肠癌的发病年龄55.79±13.58岁,明显低于pMMR肠癌患者的63.38±11.39岁(P<0.01);dMMR型肠癌发生于右侧的比例为40.5%,较pMMR肠癌患者的23.6%明显多(P<0.05);分化程度上,dMMR型肠癌低分化的比例为32.4%,较pMMR肠癌患者的12.2%明显高(P<0.01);肿瘤最大径大于5厘米的占比:dMMR型肠癌为67.6%,高于pMMR肠癌患者的40.5%(P<0.01)。而性别、病理分期、RAS/BRAF基因状态、外周血CEA水平、Ki67水平、肿瘤组织CD8+T细胞表达情况、肿瘤组织(包括肿瘤细胞和免疫细胞)的PD-L1表达情况没有明显差异(P>0.05)。结论 dMMR型结直肠癌较pMMR型结直肠癌好发于右侧、恶性度较高、确诊时肿瘤负荷较大且发病年龄较轻。更多还原

【Abstract】 Objective To investigate the clinical pathological characteristics of deficient mismatch repair colorectal cancer.Methods To take 74 cases of colorectal cancer patients diagnosed with pathologically confirmed and deficient mismatch repair(dMMR)after surgery from March 2016 to December 2018,and randomLy selected 148 cases of colorectal cancer patients with proficient mismatch repair(pMMR) as a control,and statistical analysis of clinical pathological date of two groups of patients.Results There was a significant difference in age, tumor location, differentiation, and tumor size between dMMR and pMMR patients with colorectal cancer: the age of dMMR patients with colorectel cancer was 55.79±13.58 years old, which was significantly lower than that of pMMR patients of 63.38±11.39 years old.(P<0.01); the proportion of dMMR patients with tumor cancer occurred on the right side was 40.5%,which was significantly higher than that of pMMR patients(P<0.05); the proportion of poorly differentiated of dMMR patients was32.4%, which was significantly higher than 12.1% of pMMR patients(P<0.01); the proportion of tumors with a maximum diameter of more than 5 cm: dMMR cases was 67.6%, higher than that of 40.5% of pMMR patients(P<0.01). There was no significant difference in the expression of PD-L1(including tumor cells and immune cells), gender, pathological staging, RAS/BRAF gene status, peripheral blood CEA level, Ki67 level, tumor tissue CD8+ T cell expression between patients with dMMR and pMMR(P>0.05). Conclusion The dMMR patients with colorectal cancer is more onset on the right side, poor differentiation, large tumor burden and younger than that of pMMR patients.更多还原