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Abstract：
Background Microsatellite instability (MSI) is a genetic condition caused by errors in DNA repair genes that cause colorectal cancer (CRC). The literature contradicts the frequency of MSI in sporadic CRCs and its effect on prognosis. This study investigated the distribution of clinicopathologic features and the relationship between MSI and survival outcomes. Methodology This is a retrospective study of 101 consecutive cases of CRC and immunohistochemical studies. All cases were retrospectively reviewed and reevaluated by histological grade, lymphovascular invasion, perineural invasion, tumor borders, dirty necrosis, tumor-infiltrating lymphocytes (TILs), Crohn\'s-like lymphoid reaction, mucinous and medullary differentiation, and tumoral budding from pathological slides. An immunohistochemical study was performed in appropriate blocks for using MLH-1, MSH-2, MSH-6, and PMS-2. We collected the clinical stage, pathological tumor stage, lymph node metastasis, age, sex, tumor diameter, distant metastasis, localization, and survival information from patients\' clinical data. Results There was no statistically significant difference between the two groups regarding age, gender, tumor diameter, histological grade, tumor border, dirty necrosis, TILs, N and M stage, perineural and lymphovascular invasion, mucinous differentiation, medullary differentiation, and tumor budding characteristics of the patients. The MSI-H group was more frequently located in the right colon and transverse colon (p < 0.001), and the T stage was higher among them than in the MSI-L group (p = 0.014). Upon multivariate regression analysis, MSI status had no significant effect on survival time. Age and stage N and M were independent prognostic factors for colon cancer prognosis. Conclusions Our study presented the distribution of clinicopathological features and their relationship with MSI for 101 regional CRC patients. MSI status was detected by immunohistochemistry. Identifying MSI in CRCs may help personalize therapy planning. As the distribution of the features may vary from population to population, further investigations are needed on this topic.
摘要：
背景技术微卫星不稳定性(MSI)是由DNA修复基因中的错误引起的导致结直肠癌(CRC)的遗传病。文献与散发性CRC中MSI的发生频率及其对预后的影响相矛盾。这项研究调查了临床病理特征的分布以及MSI与生存结局之间的关系。方法本研究是对101例连续CRC病例的回顾性研究和免疫组织化学研究。对所有病例进行回顾性分析，并根据组织学分级进行重新评估，淋巴管浸润,神经周浸润,肿瘤边界,肮脏的坏死，肿瘤浸润淋巴细胞（TIL），克罗恩样淋巴反应,粘液和髓质分化，和病理切片中的肿瘤出芽。在使用MLH-1、MSH-2、MSH-6和PMS-2的适当模块中进行免疫组织化学研究。我们收集了临床分期，病理肿瘤分期,淋巴结转移,年龄,性别,肿瘤直径,远处转移,本地化,和患者临床数据的生存信息。结果两组患者年龄差异无统计学意义,性别,肿瘤直径,组织学分级,肿瘤边界,肮脏的坏死，TIL,N级和M级,神经周和淋巴管浸润，粘液分化，髓质分化,和患者的肿瘤出芽特征。MSI-H组较多位于右半结肠和横结肠(p<0.001),T分期高于MSI-L组(p=0.014)。经多元回归分析，MSI状态对生存时间无显著影响。年龄、N、M期是影响结肠癌预后的独立预后因素。结论我们的研究提供了101例区域CRC患者的临床病理特征分布及其与MSI的关系。通过免疫组织化学检测MSI状态。在CRC中识别MSI可能有助于个性化治疗计划。由于特征的分布可能因人口而异，需要对此进行进一步调查。
