作者：林祺，唐维，王志雄，李广华

单位：中山大学附属第一医院 胃肠外科中心，广东 广州 510080

Authors: Lin Qi，Tang Wei，Wang Zhixiong，Li Guanghua

Unit: Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China

摘要：

目的 分析胃癌组织的微卫星不稳定状态，探讨其与临床病理因素之间的关系。方法 2020年8月至2022年5月中山大学附属第一医院胃肠外科中心接受手术治疗的胃癌患者资料，分析胃癌组织的微卫星不稳定状态，探讨相关位点突变与错配修复蛋白缺失情况，对比分析微卫星不稳定与临床病理因素的关系。结果 共275例胃癌患者被纳入研究，高度微卫星不稳定(MSI-H)占比为6.91%(19/275)，临床参数如确诊年龄、性别、肿瘤部位、病理组织类型、TNM分期、人表皮生长因子受体2(HER-2)表达情况等均未与微卫星不稳定状态有显著的统计学相关（P>0.05）。而有明确记录的BorrmannⅠ、Ⅱ、Ⅲ、Ⅳ型分别占2.7%(7/257)、25.7%(66/257)、62.65%(161/257)以及9.0%(23/257)，在微卫星稳定组/微卫星不稳定组之间具有显著统计学差异（P=0.012）,MSI-H组中并无BorrmannⅣ型的患者，而BorrmannⅠ型在低度微卫星状态(MSI-L)组中占比更高。结论 本研究中仅Borrmann分型与胃癌组织的MSI状态有关，且在MSI-H组中并无BorrmannⅣ型的患者，二者之间是否存在潜在的分子机制仍有待研究。

关键词：胃癌； 微卫星不稳定； 临床病理因素； Borrmann 分型

Abstract：

Objective To analyze the microsatellite instability state of gastric cancer tissues ，and to explore its relationship to clinicopathological characteristics. Method The microsatellite instability state of gastric cancer tissue of the patients who underwent surgery in the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Sun Yat -sen University were retrospectively analyzed ，and the to the define relationship between No.8p lymph nodes metastasis and clinicopathological parameters ，and associated site mutations or loss of mismatch repair proteins loss were described among MSI -H gastric cancer tissues. Clinical data was analyzed to explore the correlation between clinical characteristics and microsatellite instability state. Result A total of 275 patients with gastric cancer were enrolled in the study. The rate of MSI-H gastric cancer was 6.91%（19/275）. Clinical factors such as age，gender，tumor site，pathological type， TNM stage and HER-2 expression were not significantly correlated to microsatellite instability state （P>0.05） except Borrmann type （P=0.012）. The proportion of Borrmann typesⅠ，Ⅱ，Ⅲ and Ⅳ with clear records is respectively 2.7%（7/257），25.7%（66/257），62.65%（161/257） and 9.0%（23/257）. Conclusion In this study，only Borrmann type was related to the MSI status of gastric cancer tissue. There was no Borrmann type Ⅳ patients in the MSI-H group and the proportion of Borrmann Ⅰ was higher in MSI-L group. Whether there was a potential molecular mechanism between the two remains to be explored.

Key Words: Gastric cancer; Microsatellite instability; Clinicopathologic characteristics; Borrmann type