Value Of Mismatch Repair Genes Combined With Neutrophil-lymphocyte Ratio In Predicting Postoperative Recurrence Of Colon Cancer

ObjectiveTo investigate the clinicopathological characteristics of colon cancer 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.Methods1 The date of 125 patients who underwent radical resection of left/right colon cancer and were diagnosed by Postoperative pathology between April 1,2015 and April 1,2017 at the Second Affiliated Hospital of Fujian Medical University and the First Affiliated Hospital of Xiamen University were retrospectively analyzed.According to the results of immunohistochemistry,We divided the patients into deficient mismatch repair(dMMR)group(n=55)and proficient mismatch repair(p MMR)group(n=70),collecting the Blood routine examination within 3 days before surgery and Postoperative histopathological results,recording the related clinicopathological features of the patients.2 According to the ROC curve,the NLR threshold was determined as 3 and we divided patients into four groups: dMMR with low NLR,dMMR with high NLR,p MMR with low NLR and p MMR with high NLR on the basis.The recurrence and prognosis of these patients were also recorded.MMR status was determined according to the immunohistochemical results of mismatch repair proteins about MLH1,PMS2,MSH2 and MSH6,and NLR was calculated using the formula "NLR= neutrophils/lymphocytes".3 We analyzed the relationship between MMR status and clinicopathological characteristics of colon cancer patients.And grouped according to different MMR status and NLR level,followed up the patients’ recurrence-free survival for 3 years after operation and made a survival analysis curve to further explore the predictive value of MMR combined with NLR for postoperative recurrence of colon cancer.Results1 There’s no significant diffirence between MMR status and sex,gross tumor type,tumor tissue type,depth of tumor invasion,lymph node metastasis,tumor stage,serum carcinoembryonic antigen(CEA)level,serum lactate dehydrogenase(LDH)level and postoperative chemotherapy(P>0.05).2 The MMR status was positively correlated with onset age,tumor size,tumor differentiation,tumor location and tumor nerve invasion(P<0.05).3 dMMR was correlated with low NLR(P<0.05).4 The patients in the dMMR with low NLR group had a higher 3-year progression-free survival(P<0.05).5 The patients in the dMMR with low NLR group had a significant postoperative survival advantage(P<0.05).Conclusions1 dMMR colon cancer has unique clinicopathological characteristics.Compared with the p MMR group,the patients in the dMMR group had lower onset age,larger tumor size,lower differentiation and more nerve invasion,and were more likely to occur in the right hemicolon.In our clinical work,we should pay attention to the identification of colon cancer with these characteristic to improve the detection rate of dMMR status,which has guiding significance for the diagnosis and treatment2 dMMR was correlated with lower NLR.Compared with other groups,The patients in the dMMR with low NLR group have a higher 3-year progression-free survival.Therefore,MMR status combined with preoperative blood neutrophil-lymphocyte ratio can effectively evaluate the risk of postoperative recurrence of colon cancer.