作者：刘细邦1，易小江2，张志发3，刁德昌2

单位：1.深圳市龙华区中心 医院肛肠科， 广东 深圳 518110；2.广州中医药大学第二附属医院/广东省中医院 胃肠肿瘤中心结直肠外科， 广州 广东 510120；3.广州中医药大学第二附属医院/广东省中医院 病理科， 广东 广州 510120

Authors: Liu Xibang1，Yi Xiaojiang2，Zhang Zhifa3，Diao Dechang2

Unit: 1. Department of Anorectum，Shenzhen Longhua District Central Hospital，Shen Zhen 518110，Guangdong, China；2. Department of Colorectal Surgery，Gastrointestinal Tumor Center，The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine/ Guangdong Provincial Hospital of Traditional Chinese Medicine， Guangzhou，Guangdong 510120，China；3. Department of Pathology，The Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine/ Guangdong Provincial Hospital of Traditional Chinese Medicine，Guangzhou 510120, Guangdong, China

摘要：

关键词：错配修复状态缺失/高度微卫星不稳定； 结直肠癌； 临床病理； 亚组分析

Abstract：

Objective To investigate the clinicopathological characteristics of dMMR/ MSI-H colorectal cancer and their relationship. Method The clinicopathological data of 267 patients with dMMR/MSI-H phenotype colorectal cancer treated in Guangdong Hospital of Traditional Chinese Medicine from May 2016 to August 2022 were retrospectively analyzed and cross subgroup analysis was performed. Result 139 male and 128 female patients were included with an average age of (59.8±16.0) years. The common loss rate of simultaneous expression of MLH1 and PMS2 was 58.1% (154/265)，the loss rate of simultaneous expression of MSH2 and MSH6 was 18.5% (49/265)，and 90 cases (33.7%) developed regional lymph node metastasis. Subgroup analysis showed that the differentiation of right colon tumors was worse and the vascular invasion rate was higher; Patients with lymph node metastasis had worse differentiation ，higher T3 -T4 stage rate，higher neurovascular invasion and higher incidence of cancer nodules; Patients with tumor length≥8 cm had higher regional lymph node metastasis rate，worse differentiation，higher T3 -T4 stage rate，higher vascular invasion and higher incidence of cancer nodules; Patients with poor differentiation had a higher rate of stage T3-T4，vascular invasion and cancer nodules; The incidence of neurovascular invasion and cancer nodules was higher in patients with late T stage. Conclusion Colorectal cancer with dMMR/ MSI-H phenotype has unique clinicopathological characteristics and is closely related to each other.

Key Words:  dMMR/ MSI-H; Colorectal cancer; Clinicopathology; Subgroup analysis