Objective: To investigate the relationship between the expression of mismatch repair(MMR) protein and the microsatellite instability(MSI) typing in colorectal cancer(CRC) by studying the expression of MMR and MSI in colorectal cancer. We evaluate the correlation between different MSI subtypes and different chemotherapy regimens by PFS. Methods: We examined MMR protein expression levels in 130 cases of colorectal cancer using immunohistochemistry(IHC), characterized MSI typing by fluorescence polymerase chain reaction(PCR), confirmed correlations between MMR protein expression and the MSI typing, and analyzed for the correlation between MSI expression and clinicopathological characteristics. Based on the retrospective study, we analyzed the difference of progression free survival(PFS) between patients with different MSI classification and different chemotherapy drugs. Results: The rate of MMR deletion(dMMR) was 26.9%(35/130), and the detection rate of MSI-H was 23.8%(31/130).There was a correlation between MMR protein expression and MSI expression(P<0.001). MSI type had no significant correlation with age(P=0.639), gender(P=0.378), location(P=0.418), or stage(P=0.225). Survival analysis showed that the recurrence time of the MSI-H group was less than that of the non-MSI-H group for the FOLFOX4 regimen, while no statistical difference between the MSI-H group and the non-MSI-H group was found in the XELOX chemotherapy group and the untreated group. Conclusion: The expression level of MMR protein is highly consistent with the status of MSI, suggesting that immunohistochemistry may be used as a preliminary screening method. For MSI-H patients with indications of chemotherapy, XELOX chemotherapy is recommended. |
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