1. The Prognostic Value of Deficient Mismatch Repair in Stage II–IVa Nasopharyngeal Carcinoma in the Era of IMRT
- Author
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Jian-fang Gao, Hong-xing Kan, Yun-Xiang Zhang, Ming-chen Wang, Ya-nan Zhang, Shi-geng Zhang, Ya-ting Zhang, Fu-Rong Hao, Fang-ming Chen, Han Li, Cheng Li, Yang Li, Xiu-feng Li, Hao Ma, and Xiao-li Wang more...
- Subjects
Male ,0301 basic medicine ,Oncology ,Biopsy ,medicine.medical_treatment ,lcsh:Medicine ,DNA Mismatch Repair ,0302 clinical medicine ,PMS2 ,Stage (cooking) ,Child ,lcsh:Science ,Cancer ,Mismatch Repair Endonuclease PMS2 ,Aged, 80 and over ,Nasopharyngeal Carcinoma ,Multidisciplinary ,Middle Aged ,Prognosis ,DNA-Binding Proteins ,MutS Homolog 2 Protein ,030220 oncology & carcinogenesis ,Female ,MutL Protein Homolog 1 ,Adult ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Adolescent ,Article ,Disease-Free Survival ,Young Adult ,03 medical and health sciences ,Medical research ,Internal medicine ,medicine ,Humans ,Aged ,Neoplasm Staging ,Proportional hazards model ,business.industry ,lcsh:R ,Nasopharyngeal Neoplasms ,medicine.disease ,digestive system diseases ,Radiation therapy ,MSH6 ,030104 developmental biology ,Nasopharyngeal carcinoma ,MSH2 ,lcsh:Q ,Radiotherapy, Intensity-Modulated ,business - Abstract
In the era of intensity-modulated radiotherapy (IMRT), it is important to analyse the prognostic value of deficient mismatch repair (dMMR) in nasopharyngeal carcinoma (NPC). In this study, in pretreatment biopsies of 69 patients with stage II–IVa NPC, the expression levels of MMR proteins, including MLH1, MSH2, MSH6 and PMS2, were assessed by immunohistochemistry (IHC). The median follow-up time was 37.5 months (3.1–87.4 months). 50.7% of cases (35/69) showed preserved expression of all 4 MMR proteins, which was interpreted as proficient mismatch repair (pMMR). Only 1.5% of cases (1/69) lost expression of all 4 MMR proteins, 26.1% of cases (18/69) have PMS2 loss alone and 21.7% of cases (15/69) lost expression of both PMS2 and MLH1. Thus, 49.3% of cases (34/69) lost expression of one or more MMR proteins, which was interpreted as dMMR. There was no significant difference (P > 0.05) in terms of sex, age, clinical stage, T category, N category or therapy regimens between the dMMR and pMMR groups. The multivariate Cox regression analysis revealed that dMMR was an independent significant prognostic factor for distant metastasis-free survival (DMFS) (dMMR vs pMMR: P = 0.01, HR = 0.25, 95% CI: 0.09~0.75). Therefore, NPC patients with dMMR had significantly superior DMFS compared with patients with pMMR. It can be expected that dMMR will become a new independent prognostic factor for NPC. more...
- Published
- 2020
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