微卫星的不稳定性在不匹配修复熟练的结直肠癌:临床特征和潜在的分子机制
1Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, PR China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
EBioMedicine
|May 1, 2024
概括
不匹配修复 (dMMR) 和高微卫星不稳定性 (MSI-H) 的缺陷是结直肠癌 (CRC) 的关键生物标志物. 这项研究确定了一个独特的pMMR/MSI-HCRC亚组,具有独特的免疫特征和MSH3突变,提供了新的诊断潜力.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 免疫学 免疫学 免疫学
背景情况:
- 不匹配修复缺陷 (dMMR) 和高微卫星不稳定性 (MSI-H) 是已确定的结直肠癌 (CRC) 生物标志物.
- 越来越多的MSI-H瘤在熟练的不匹配修复 (pMMR) CRC中被发现,需要进一步调查.
- 了解pMMR/MSI-HCRC的临床和分子特征对于完善诊断和治疗策略至关重要.
研究的目的:
- 研究具有熟练不匹配修复和高微卫星不稳定性 (pMMR/MSI-H) 结直肠癌患者的临床特征和预后结果.
- 阐明驱动pMMR/MSI-HCRC表型的潜在分子机制.
- 在pMMR/MSI-H CRC.中探索瘤免疫微环境特征.
主要方法:
- 在2015年1月至2018年12月期间诊断的1684例pMMR和401例dMMRCRC病例的回顾性分析.
- 对93个pMMR/MSI-HCRC病例的鉴定和临床表型.
- 在35 pMMR/MSI-H CRC组织样本上进行了全面的基因组和转录组分析.
主要成果:
- 与pMMR/MSS CRC相比,pMMR/MSI-H CRC显示瘤进展显著减少,长期预后更好.
- 在pMMR/MSI-H队列中,CD8+ T细胞和NK细胞的透率增加.
- 突变特征分析显示,在pMMR/MSI-H样本中,MSH3 (MSH3-K383fs) 经常出现有害突变.
结论:
- pMMR/MSI-H CRC代表了一个独特的亚组,具有独特的临床病理特征和预后影响.
- 瘤免疫微环境在pMMR/MSI-H CRC中显著不同.
- 致病性MSH3突变在pMMR/MSI-HCRC中很常见,这表明它们有可能成为MSI-H识别的新生物标志物.
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