摘要: |
微卫星不稳定性(microsatellite instability,MSI)是指DNA错配修复(mismatch repair,MMR)功能出现异常,微卫星复制错误得不到纠正并不断累积,使微卫星序列长度或碱基组成改变。8%~25%胃癌患者为MSI型。微卫星高度不稳定性(microsatellite instability-high,MSI-H)胃癌患者预后相对较好,但与微卫星稳定性(microsatellite stability,MSS)胃癌患者相比,MSI-H患者无法通过围手术期化疗提高生存获益,部分免疫治疗改善晚期MSI-H胃癌患者预后的效果优于化疗。目前各项研究中MSI患者较少,且大多为回顾性分析,因此MSI是否为围手术期化疗效果不佳的预测因素尚未明确。本文就近年来MSI对胃癌患者治疗影响的研究进展作一综述。 |
关键词: 胃癌 微卫星不稳定 预后 预测因素 免疫治疗 |
DOI:10.12025/j.issn.1008-6358.2022.20220405 |
分类号:R735.2 |
基金项目:上海市2019年度"科技创新行动计划"自然科学基金(19ZR1456100). |
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Advances in the effect of microsatellite instability on treatment of gastric cancer |
ZHENG Rui, NIE Ming-ming
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Department of Gastrointestinal Surgery, the First Hospital of Naval Medical University, Shanghai 200433, China
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Abstract: |
Microsatellite instability (MSI) refers to the abnormal occur of DNA mismatch repair function (MMR), and the replication errors of microsatellites cannot be corrected. The accumulation of replication errors leads to change of the length or base composition of the microsatellite. There are 8%-25% of gastric cancer patients presenting MSI. The prognosis of microsatellite instability-high (MSI-H) gastric cancer patients is relatively better. However, compared with microsatellite stability (MSS) gastric cancer patients, MSI-H patients may not benefit from perioperative chemotherapy in survival. In some patients with advanced MSI-H gastric cancer, the effect of immunotherapy improve survival is better than chemotherapy. There are a few MSI-H patients in the past retrospective researches and that whether MSI is a negative predictor for perioperative chemotherapy effect is unknown. This paper reviews progress in impacts of MSI on treatment of gastric cancer in resent years. |
Key words: gastric cancer microsatellite instability prognosis predictor immunotherapy |