| Objective:To detect MMR proteins expression in sporadic colon cancer and to analyze correlation MMR proteins expression with clinical characteristics and survival time, to explore the possibility of being to a prognostic indicator of survival time.Methods:Collected the patients with Ⅱ stage colon adenocarcinoma who underwent curative surgical resectionin between July 31,2008 and July 31, 2013 at the Fourth Affiliated Hospital of Guangxi Medical University. The patients were assigned to surgery alone or surgery plus adjuvant 5-FU based chemotherapy according to with adjuvant chemotherapy or without adjuvant chemotherapy. MMR status was determined by immunohistochemical (IHC) analysis of hMLHl and hMSH2 expression, according to the result of IHC can be divided into two groups, a tumor was considered dMMR when either there was loss of hMLH1 or hMSH2 protein expression, pMMR when either there was the hMLH1.or the hMSH2 prbtein after 6 periods of the EOLFOX or 8 periods of the CapeOX adjuvant chemotherapy, followed up-DFS, analysising correlation MMR protein expression with clinical characteristics and survival time.Results:The patients of adjuvant 5-FU based chemotherapy 75 cases were collected, the patients of surgery alone 42 cases were collected. In chemotherapy group,48 cases aged≤60,27 cases> 60,33 cases is male, 42 cases is female,43 cases of tumor differentiation is high-Middle,32 cases is low,45 cases is T3 stage,30 cases is T4 stage. In surgery alone group,28 cases aged≤60,14 cases>60,16 cases is male,26 cases is female, 25 cases of tumor differentiation is high-Middle,17 cases is low,24 cases is T3 stage,18 cases is T4 stage. In the patients of adjuvant 5-FU based chemotherapy, 10(13.33%) showed loss of hMLHl,65 showed abnormal hMLH1,16(21.33%) showed loss of hMSH2,59 showed abnormal hMSH2, the MMR protein loss rate was 34.66%, in the patients of surgery alone,9(21.43%) showed loss of hMLH1,33 showed abnormal hMLHl,5(11.90%) showed loss of hMSH2,37 showed abnormal hMSH2, the MMR protein loss rate was 33.33%. A loss of hMLHl/hMSH2 protein expression was correlated to the degree of tumor differentiation(P< 0.05), the loss rate of MMR protein expression in patients of adjuvant 5-FU based chemotherapy with T3, T4 was 22.22%,53.33%, the loss rate of MMR protein expression in patients of surgery alone with T3, T4 was 16.67%,55.56%, respectively, the loss rate of MMR protein expression increased with T stage increasing(P< 0.05), but not correlated to gender and age(P> 0.05). According to the results of follow-up, in the patients of adjuvant 5-FU based chemotherapy group have 21 cases experienced local recurrence, metastasis and death, which 17 cases for pMMR group,4 cases for dMMR group, in the patients of surgery alone group have 7 cases experienced local recurrence, metastasis and death, which 4 cases for pMMR group,3 cases for dMMR group. Whether chemotherapy group or surgery alone group, patients with dMMR tumors showed a better clinical outcome than patients with pMMR carcinomas(P< 0.05). The MMR status did not predict survival benefit from adjuvant 5-FU-based chemotherapy(P>0.05).Conclusion:MMR protein expression was correlated to the degree of tumor differentiation and T stage. MMR protein can yield important a prognostic indicator for clinical outcome but is not a predictive factor for adjuvant 5-FU-based chemotherapy in sporadic colon cancer. However, a large-scale prospective study is warranted to validate our findings. |
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