Objective To discuss expression of hMLH1, hMSH2 and hMSH6 protein in the young and middleaged patients with sporadic gastric cancer (SGC) and their effects on prognosis. Methods To collect 147 cases of SGC paraffin specimens from January 2010 to January 2013 and to analyze the relationship between the expression of mismatch repair protein (MMR) and its clinic pathological features and prognosis. Immunohis-tochemistry was used to detect the expression of h MLH1, hMSH2 and h MSH6 in young SGC. Results The deletion rate of hMLH1 was 20.4％ (30/147), that of hMSH2 7.5％ (11/147) and that of hMSH6 6.1％ (9/147) .The total deletion rate of MMR was 28.6％ (42/147) . The deletion of MMR was significantly different in pTNM stage, tumor differentiation degree and lymph node metastasis (P ＜ 0.05) . The five-year overall survival rate was 64.3％ (27/42) in the deficient mismatch repair protein (dMMR) group and 80.9％ (85/105) in the normal MMR group, and the difference was statistically significant (χ2=4.950, P ＜ 0.05. The multivariate analysis showed that MMR status and lymph node metastasis were independent factors influencing the overall survival time in patients with SGC. Conclusions MMR deletion in young and middle-aged patients with SGC is more common in patients with stage Ⅲ and low differentiation. The deletion MMR group was more likely to undergo lymph node metastasis. The prognosis of the dMMR group was worse than that of the normal MMR group. h MLH1, hMSH2 and hMSH6 may play an important role in the occurrence and development of gastric cancer. Joint detection has a certain value in the diagnosis and treatment of gastric cancer.%目的 探讨hMLH1、h MSH2、hMSH6在中青年散发性胃癌 (SGC) 中的表达及对其预后的影响.方法 收集2010年1月—2013年1月SGC术后石蜡标本147例,采用免疫组织化学法检测中青年SGC中hMLH1、hMSH2、hMSH6蛋白的表达情况,分析错配修复蛋白 (MMR) 阴性表达与其临床病理特征及预后之间的关系.结果 hMLH1、hMSH2、hMSH6的阴性表达率分别为20.4％ (30/147) 、 7.5％ (11/147) 、 6.1％ (9/147),MMR总阴性表达率为28.6％ (42/147).MMR阴性表达在p TNM分期、分化程度和淋巴结转移间的差异均有统计学意义 (P ＜0.05).MMR阴性表达组的5年总生存率为64.3％ (27/42),低于MMR正常组80.9％ (85/105),差异有统计学意义 (χ2=4.950,P ＜0.05).多因素分析显示,MMR状态、有无淋巴结转移是影响SGC患者总生存时间的独立因素 (P ＜0.05).结论 中青年SGC患者MMR阴性表达多见于Ⅲ期、低分化的患者,更容易发生淋巴结转移;MMR阴性表达组患者较MMR正常组患者预后差,hMLH1、hMSH2、hMSH6可能在胃癌的发生、发展中起重要作用,联合检测对胃癌的诊断与治疗有一定价值.
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