"台灣地區大腸直腸癌微衛星不穩定性(Microsatellite instability, MSI)的表現"

Abstract

本論文的目的利用微小衛星不穩定性(Microstatellite instability)與遺傳性非瘜肉症結直 腸癌(Hereditary non-polyposis colorectal cancer, HNPCC)的高度相關的特性,來分析台灣地 區微小衛星不穩定性在大腸直腸癌的表現,以作為臨床上評估大腸直腸癌患者預後的情況。 隨著台灣地區飲食習慣西化的影響,導致台灣地區大腸直腸癌發生率有逐年增加的情 況。除了飲食習慣等環境因素影響外,與遺傳基因有關的大腸直腸癌大約佔 15%。 本研究共收集了經臺大醫院確診的大腸直腸癌患者 265 位,分別為 89 位第二期患者與 176 位第四期患者,利用 Fluorescence Multiplex Polymerase Chain Reaction 與毛細管電泳分 析,來偵測台灣地區微衛星不穩定性在大腸直腸癌的表現。 結果顯示大腸直腸癌第四期患者較第二期患者在年紀、性別、MSS 的表現均有顯著差異, 反觀在第二期與第四期的 MSI-H 表現則沒有顯著差異性。而進一步比較第二期與第四期大腸 直腸癌患者在性別上的表現是無差異性的,且在年紀上也無差異性。本實驗結果與美國 Hatch SB, Lightfoot HM 等人在 2010 年北卡羅來納州所實驗的結果相近。

The objective of this study is to utilize the high relevance of the characteristics of Microsatellite instability and Hereditary non-polyposis colorectal cancer (HNPCC) and to analyze the performance of Microsatellite instability and colorectal cancer in Taiwan and in the assessment of prognosis of colorectal cancer patients. With the westernization of the eating habits in Taiwan, incidence of colorectal cancer in Taiwan increases through the years, Aside from eating habits and environmental factors, heredity may also stands approximately 15% of possible causes. This study collected data from 265 subjects diagnosed with colorectal cancer in the National Taiwan University Hospital, of which 89 subjects are in the 2nd stage and 176 subjects in the 4th stage, using the Fluorescence Multiplex Polymerase Chain Reaction and capillary electrophoresis method to detect the performance of microsatellite instability in colorectal cancer in Taiwan. Results show significant difference observed in subjects with 4th stage and 2nd stage subjects in their ages, gender and MSS performance, but in contrast, there is so significant difference seen in MSI-H performance. To further compare subjects in the 2nd and 4th stages, there is no significant difference neither in gender nor in age The observed outcome is very similar to that made by USA Hatch SB, Lightfoot HM et al. in 2010 in North Carolina.