MSI、HGF 与大肠癌患者预后关系的初步研究

Influences of microsatellite instability and hepatocyte growth factor on prognosis of patients with colorectal cancer

摘要:

目的 探讨微卫星不稳定性（MSI）和肝细胞生长因子（HGF）对大肠癌患者预后的影响。方法选取2011 年4 月-2014 年7 月四川省巴中市中医医院收治的大肠癌患者80 例，记录MSI 患者和HGF 阳性患者的生存率，对患者的临床资料进行单因素和COX 回归分析。结果 MSI 患者14 例，1、3 和5 年生存率分别为92.86%、85.71% 和71.43% ；非MSI 患者14 例，1、3 和5 年生存率分别为92.42%、74.24% 和56.06%。HGF 阳性患者14 例，1、3 和5 年生存率分别为89.47%、73.68% 和54.39% ；HGF 阴性患者14 例，1、3 和5年生存率分别为100.00%、82.61% 和73.91%。不同大体类型、TNM 分期、分化程度、是否淋巴结转移、辅助化疗、MSI、HGF 阳性和阴性患者的5 年生存率比较，差异有统计学意义（P <0.05）。TNM 分期Ⅲ、Ⅳ，以及淋巴结转移、HGF 阳性是影响大肠癌患者生存状况的独立危险因素，辅助化疗和MSI 是患者生存的保护因素（P <0.05）。结论 MSI、HGF 与大肠癌患者预后密切相关，其中MSI 患者比非MSI 患者预后佳，而HGF 阳性患者预后较阴性患者差。

Abstract:

Objective To investigate the effect of microsatellite instability (MSI) and hepatocyte growth factor (HGF) on the prognosis of patients with colorectal cancer. Methods Eighty patients with colorectal cancer in our hospital from April 2011 to July 2014 were selected. The survival rates of the patients with MSI and the HGFpositive patients were recorded. The clinical data of the patients were analyzed with univariate and COX regression analyses. Results In the 14 cases of MSI patients, 1-, 3- and 5-year survival rates were 92.86%, 85.71% and 71.43% respectively; in the 66 cases of the non-MSI patients, 1-, 3-, 5-year survival rates were 92.42%, 74.24% and 56.06% respectively. In the 57 cases of HGF-positive patients, 1-, 3- and 5-year survival rates were 89.47%, 73.68% and 54.39% respectively; while in the 23 cases of HGF-negative patients, 1-, 3- and 5-year survival rates were 100.00%, 82.61% and 73.91% respectively. There were significant differences in the 5-year survival rates of the patients with different pathological types, TNM stages, differentiation degree, lymph node metastasis, adjuvant chemotherapy, MSI and HGF expressions (P < 0.05). TNM stage III and IV, lymph node metastasis and HGF positivity were the independent risk factors influencing the survival status of the colorectal cancer patients. Adjuvant chemotherapy and MSI were the protective factors for the survival of the patients (P < 0.05). Conclusions MSI and HGF are the main factors influencing the prognosis of the patients with colorectal cancer. MSI patients have a better prognosis than non-MSI patients, whereas HGF-positive patients have a worse prognosis than HGF-negative patients.