DNA Mismatch Repair Genes Deficiency Affect The Prognosis Of Patients With Stage Ⅱ Colon Cancer

Object:1、Detection stage Ⅱ colon cancer patients DNA mismatch repair genes deficiency in tumor tissues.2、DNA mismatch repair genes deficiency and the correlation of the tumor and prognostic analysis.Method:Time since January1,2002to December31, retrospective analysis the stage Ⅱ patients with colon cancer radical surgery in the second affiliated hospital of dalian medical university.There are total164cases patients with pathological and follow-up data integrity, meanwhile,can obtain complete histological wax block, for all patients with a DNA mismatch repair gene immunohistochemical detection.Investigate DNA mismatch repair gene expression with related postoperative pathologic characteristics and its influence on prognosis.All the data by SPSS17.0software for statistical analysis.The chi-square analysis of DNA mismatch repair gene defects related pathologies whether there is a difference,though Log-Rank single factor analysis, Survival analysis by Kaplan Meier method, survival curve drawing at the same time.Result:There are total177patients,13cases of lost to follow-up. A total of164patients with complete follow-up data and intact wax block. In164cases of patients with a DNA mismatch repair gene immunohistochemical detection.Follow-up period, a total of44cases of recurrence and metastasis,27cases death, including2cases of non cancer-related death, Disease free survival was73.2%for five years, Overall survival was83.5%.DMMR37cases of patients, lack expression rate was22.6%.1、DNA mismatch repair gene state pathological features:gender (male, female), age(<65岁≥65岁),differentiated degree(high-moderately differentiated, poorly differentiated), T(T3, T4), tumor site (proximal, the remote), the CEA preoperatively (<5ng/ml、≥5ng/ml), Whether preoperative intestinal obstruction(without obstruction, obstruction), surgical removal of the lymph node number (<12个、≥12个), each subgroup analysis suggests dMMR occurs in the colon proximal and pathologic differentiation degree of poor in stage Ⅱ colon cancer patients.2、37patients with dMMR,5cases recurrence and metastasis(13.5%),2case death (5.4%), pMMR patients127cases,41cases recurrence and metastasis (32.3%),25cases death (19.7%), through the Log-Rank method for DFS and OS the single factor analysis, P values were0.034and0.043, have statistically significant. Subgroup analysis,88patients with surgery alone, dMMR patients surgical group20cases (10%)2cases of recurrence and transfer, no deaths, pMMR scores68cases patients,28cases of recurrence and transfer (41.1%),17deaths (25%), P values of5years DFS and OS are0.014and0.017respectively, have statistically significant.It is suggest dMMR is indepent prognostic factor and good biological indicator to effect a radical cure postoperative in stage Ⅱ colon cancer patients.3> dMMR in patients with surgical group20cases,2cases recurrence and metastasis (10%),0case death, chemotherapy group of17cases,3cases recurrence and metastasis (17.6%),2case death (11.8%),P values were0.453and0.119, no statistical significance.dMMR patients cannot benefit from postoperative adjuvant chemotherapy.Conclusion:1.dMMR occurs in the colon proximal and pathologic differentiation degree of poor in stage Ⅱ colon cancer patients.2.dMMR is indepent prognostic factor and good biological indicator to effect a radical cure postoperative in stage Ⅱ colon cancer patients.3.dMMR patients cannot benefit from postoperative adjuvant chemotherapy Further large sample observation.