摘要目的：探讨微卫星不稳定性（ MSI）和肝细胞生长因子（ HGF）在结直肠癌发病机制中的作用及其对患者预后的影响。方法应用免疫组化法检测98例结直肠癌组织中MSI和HGF的表达情况，比较MSI组和微卫星稳定（ MSS）组患者的预后情况。结果98例结直肠癌患者中，MSI的发生率为32．7％，且右半结肠较左半结肠和直肠多发（P＝0．040），MSI组患者的肿瘤分化程度高于MSS组（P＝0．046）。 MSI组患者的HGF阳性率（84．4％）高于MSS组（65．2％，P＝0．048）。 MSI组和MSS组患者的5年生存率分别为39．8％和58．7％，差异有统计学意义（ P＝0．009）；HGF阳性组和阴性组患者的5年生存率分别为46．2％和67．9％，差异有统计学意义（ P＝0．035）。 Cox多因素分析结果显示，淋巴结转移情况、TNM分期、MSI和HGF表达情况均为影响患者预后的独立因素（均P＜0．05）。结论在结直肠癌MSI患者中HGF的阳性率更高；MSI现象和HGF高表达为影响结直肠癌患者预后的独立因素。

abstractsObjective To investigate the expression of hepatocyte growth factor ( HGF ) and its relationship with microsatellite instability ( MSI) and their influence on survival in patients with colorectal cancer. Methods Immunohistochemistry ( IHC) was used to detect the expression of HGF and MSI in 98 specimens of colorectal cancer. Tumors lacking protein expression of any of the four mismatch repair genes (MLH1, PMS2, MSH2 or MSH6) were labelled as MSI, and the rest were considered as microsatellite stable ( MSS) . The associations between expression and clinicopathological factors were assessed using Chi?square tests. Kaplan?Meier curves, log?rank test, and Cox regression were used to analyze the association between biomarker expressions and overall survival. Results The incidence rate of MSI in 98 colorectal specimens was 32. 7%, and was statistically significantly correlated with the location of tumor and differentiation degree ( P<0.05) . The HGF?expression rate was 71.4%. The patients with an MSI tumor had a significantly higher HGF expression, compared with the patients with an MSS tumor (P=0.048). The 5?year survival rate of MSI group and MSS group were 39.8% and 58.7%, respectively (P=0.009). The 5?year survival rate of HGF?positive group and HGF?negative group were 46.2% and 67.9% ( P=0.035) . The multivariate analysis showed that lymphocytic infiltration, TMN stage, MSI and HGF are independent prognostic factors in colorectal cancer ( P<0. 05 for all ) . Conclusions HGF is highly expressed in colorectal cancer patients with microsatellite instability. Both microsatellite instability and HGF are independent factors affecting the prognosis in patient with colorectal cancer.