| Popis: |
Background MSI CRCs were associated with better prognosis and limited predictive value for adjuvant chemotherapy. However, whether the same is true in Northeastern China is still unclear. The aim of the present study was to evaluate the association of clinicopathologic features and MMR/MSI status determined with immunohistochemistry analysis in Northeast China patients with stage Ⅱ/Ⅲ CRCs. Particularly, we sought to detect the relationship between MMR/MSI status and efficacy of oxaliplatin and fluoropyrimidine based adjuvant chemotherapy.MethodsIn total, 476 pathological specimens from eligible stage Ⅱ/Ⅲ CRCs were analyzed with IHC between 2016 and 2018, of which 63 CRCs were diagnosed with MMR protein deficiency. Clinicopathological features and overall survival (OS) were compared between these above two groups. Result The incidence of dMMR CRCs in our cohort was 13.2 % (63/476). Immunohistochemistry (IHC) revealed two common dMMR IHC patterns in 63 dMMR CRCs. And dMMR type1 showed a higher proportion of women (P=0.001) and earlier pathological N stage (P=0.075). In the multivariate Cox regression model, POC and dMMR were associated with a favor prognosis in CRC patients with stage II/III (HR 0.47, 95%CI 0.30-0.74, P=.001; HR 0.34, 95%CI 0.14-0.79, P=.013). However, adjuvant chemotherapy based on oxaliplatin and fluorouracil cannot prolong the OS of dMMR CRCs (P=0.182). Conclusions MMR protein appeared distinct associations with tumor staging, serum CEA level and tumor size. And MMR protein was an independent prognostic marker in patients with stage Ⅱ CRC, whereas dMMR CRC patients did not seem to benefit from oxaliplatin combined with fluorouracil-based adjuvant chemotherapy. |
