{"id":32666,"date":"2024-05-06T12:01:37","date_gmt":"2024-05-06T12:01:37","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=32666"},"modified":"2024-05-06T12:01:37","modified_gmt":"2024-05-06T12:01:37","slug":"%e7%97%85%e7%90%86%e5%b9%b2%e8%b4%a7-%e7%bb%93%e7%9b%b4%e8%82%a0%e9%94%af%e9%bd%bf%e7%8a%b6%e7%99%8c%e5%8f%98%e7%9a%84%e5%88%86%e5%ad%90%e7%89%b9%e5%be%81","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=32666","title":{"rendered":"\u75c5\u7406\u5e72\u8d27 | \u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u764c\u53d8\u7684\u5206\u5b50\u7279\u5f81"},"content":{"rendered":"

\u4e16\u754c\u536b\u751f\u7ec4\u7ec7\u56fd\u9645\u764c\u75c7\u7814\u7a76\u673a\u6784\uff08IARC\uff09\u53d1\u5e03\u76842020\u5e74\u5168\u7403\u6700\u65b0\u764c\u75c7\u8d1f\u62c5\u6570\u636e\u663e\u793a[1]<\/sup>\uff1a\u4e2d\u56fd\u7ed3\u76f4\u80a0\u764c\u53d1\u75c5\u7387\u8dc3\u5c45\u7b2c\u4e8c\u4f4d\uff0c\u65b0\u53d1\u4eba\u6570\u8fbe55\u4e07\u3002\u6b7b\u4ea1\u7387\u4f4d\u5c45\u7b2c\u4e94\u4f4d\uff0c\u65b0\u589e\u6b7b\u4ea1\u4eba\u657028\u4e07\uff08\u89c1\u56fe1\uff09\u3002\u968f\u7740\u4e2d\u56fd\u8001\u9f84\u5316\u793e\u4f1a\u7684\u5230\u6765\u53ca\u751f\u6d3b\u65b9\u5f0f\u7684\u53d8\u5316\uff0c\u6211\u56fd\u7ed3\u76f4\u80a0\u764c\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u4e5f\u5728\u9010\u5e74\u5347\u9ad8\u3002\u8bca\u65ad\u65f6\u5e38\u5df2\u662f\u4e2d\u665a\u671f\uff0c\u9884\u540e\u4e0d\u4f73\uff0c\u8fdc\u5904\u8f6c\u79fb\u662f\u7ed3\u76f4\u80a0\u764c\u60a3\u8005\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u3002\u75be\u75c5\u8d1f\u62c5\u6c89\u91cd\uff0c\u4e25\u91cd\u5a01\u80c1\u4eba\u6c11\u751f\u547d\u5065\u5eb7\u3002\u56e0\u6b64\uff0c\u964d\u4f4e\u6211\u56fdCRC\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u5df2\u6210\u4e3a\u523b\u4e0d\u5bb9\u7f13\u7684\u91cd\u5927\u4e34\u5e8a\u533b\u5b66\u96be\u9898\u3002<\/p>\n

\u56fe1 2020\u5e74\u4e2d\u56fd\u5e38\u89c1\u65b0\u53d1\u53ca\u6b7b\u4ea1\u764c\u75c7\u4e3b\u8981\u7c7b\u578b\u3001\u4eba\u6570\u53ca\u5360\u6bd4<\/p>\n

2020\u5e74\uff0c\u56fd\u5bb6\u6d88\u5316\u7cfb\u7edf\u75be\u75c5\u4e34\u5e8a\u533b\u5b66\u7814\u7a76\u4e2d\u5fc3\uff08\u4e0a\u6d77\uff09\u7275\u5934\u53ec\u5f00\u4e86\u4e2d\u56fdCRC\u764c\u524d\u75c5\u53d8\u548c\u764c\u524d\u72b6\u6001\u4e13\u5bb6\u5171\u8bc6\u8ba8\u8bba\u4f1a\uff0c\u603b\u7ed3\u51fa\u9488\u5bf9CRC\u764c\u524d\u75c5\u53d8\u548c\u72b6\u6001\u7684\u6982\u5ff5\u754c\u5b9a\u3001\u8bca\u6cbb\u8981\u70b9\u548c\u968f\u8bbf\u7b56\u7565\uff0c\u4ee5\u671f\u5bf9\u6b64\u7c7b\u75be\u75c5\u53ca\u72b6\u6001\u7684\u65e9\u8bca\u65e9\u6cbb\u53ca\u79d1\u5b66\u7ba1\u7406\u8fdb\u884c\u6307\u5bfc\uff0c\u964d\u4f4eCRC\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\uff0c\u4ece\u800c\u5b9e\u73b0CRC\u7684\u6709\u6548\u9884\u9632[2]<\/sup>\u3002\u7ed3\u76f4\u80a0\u764c\u4e3b\u8981\u7684\u764c\u524d\u75c5\u53d8\u6709\u4f20\u7edf\u817a\u7624\u3001\u708e\u6027\u75c5\u53d8\uff0c\u952f\u9f7f\u72b6\u75c5\u53d8\u7b49\u3002\u8fc7\u53bb\uff0c\u4eba\u4eec\u666e\u904d\u8ba4\u4e3a\u4f20\u7edf\u817a\u7624\uff08\u7ba1\u72b6\/\u7ed2\u6bdb\u72b6\/\u7ba1\u72b6-\u7ed2\u6bdb\u72b6\u817a\u7624\uff0c\u4f4e\/\u9ad8\u7ea7\u522b\u5f02\u578b\u589e\u751f\uff09\uff0c\u662f\u5bfc\u81f4\u6563\u53d1\u6027\u7ed3\u76f4\u80a0\u764c\u552f\u4e00\u7684\u764c\u524d\u75c5\u53d8\uff0c\u5bf9\u4e8e\u817a\u7624\u764c\u53d8\u7684\u76f8\u5173\u5206\u5b50\u6539\u53d8\u53ca\u5206\u5b50\u901a\u8def\u7684\u7814\u7a76\u76ee\u524d\u4e5f\u5df2\u6bd4\u8f83\u660e\u786e\u3002\u800c\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\uff08colorectal serrated lesions,CSL\uff09\u662f\u6307\u9690\u7a9d\u4e0a\u76ae\u5448\u952f\u9f7f\u72b6\u7ed3\u6784\u7684\u4e00\u7ec4\u5f02\u8d28\u6027\u7ed3\u76f4\u80a0\u75c5\u53d8\uff0c\u5206\u4e3a\u589e\u751f\u6027\u606f\u8089\uff08HP\uff09\u3001\u65e0\u8482\uff08\u5e7f\u57fa\uff09\u952f\u9f7f\u72b6\u817a\u7624\/\u606f\u8089\uff08SSA\/P\u6216SSL\uff09\u3001\u4f20\u7edf\u952f\u9f7f\u72b6\u817a\u7624\uff08TSA\uff09\u4e09\u79cd\u7c7b\u578b\u3002\u5177\u6709\u72ec\u7279\u7684\u5f62\u6001\u5b66\u7279\u70b9\u3001\u751f\u7269\u5b66\u884c\u4e3a\u548c\u5206\u5b50\u9057\u4f20\u5b66\u6539\u53d8\u3002\u5176\u4e2dSSL\u548c TSA\u5177\u6709\u6076\u6027\u6f5c\u80fd\uff0c\u7ea6\u670915-30%\u7684\u6563\u53d1\u6027\u7ed3\u76f4\u80a0\u764c\u901a\u8fc7\u6b64\u9014\u5f84\u8fdb\u5c55\u800c\u6765\uff0c\u662f\u533a\u522b\u4e8e\u817a\u7624\u3001Lynch \u7efc\u5408\u5f81\u7b49\u7279\u5f81\u6027\u7684\u764c\u53d8\u9014\u5f84\u3002\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u8bef\u8bca\u7387\u3001\u6f0f\u8bca\u7387\u548c\u4e0d\u5b8c\u5168\u5207\u9664\u7387\u5747\u8f83\u9ad8\uff0c\u6545\u52a0\u5f3a\u5bf9CSL\u7684\u8ba4\u8bc6\uff0c\u5c3d\u65e9\u5e72\u9884\uff0c\u5bf9\u4e8eCRC\u7684\u9884\u9632\u6709\u91cd\u8981\u610f\u4e49[3]<\/sup>\u3002<\/p>\n

01<\/p>\n

\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84<\/p>\n

\u4ee5SSL\u548cTSA\u4e3a\u4ee3\u8868\u7684\u952f\u9f7f\u72b6\u75c5\u53d8\u5177\u6709\u5411\u7ed3\u76f4\u80a0\u764c\u53d1\u5c55\u7684\u6076\u6027\u6f5c\u80fd\uff0c\u8fd9\u4e00\u8fc7\u7a0b\u4f34\u968f\u7740\u591a\u79cd\u57fa\u56e0\u7a81\u53d8\u73af\u8282\uff0c\u79f0\u4e3a\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u3002\u5728\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u4e2d\u8d77\u51b3\u5b9a\u6027\u4f5c\u7528\u7684\u5305\u62ec\u4ee5\u4e0b\u51e0\u4e2a\u73af\u8282[4]<\/sup>\uff1a1\uff09MAPK \u901a\u8def\u7684\u6fc0\u6d3b\uff1b2\uff09\u591a\u79cd\u57fa\u56e0\u9ad8\u5ea6\u6216\u4f4e\u5ea6 CpG \u5c9b\u7532\u57fa\u5316\u8868\u578b\uff08CpG island methylator phenotype, CIMP\uff09\u3002\u867d\u7136\u5fae\u536b\u661f\u4e0d\u7a33\u5b9a\uff08Microsatellite instability, MSI\uff09\u5728\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u4e2d\u4e5f\u8d77\u7740\u91cd\u8981\u7684\u4f5c\u7528\u4f46\u5176\u4e0d\u662f\u5fc5\u8981\u73af\u8282\u3002\u6982\u62ec\u6765\u8bf4\uff0c\u76ee\u524d\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u5047\u8bf4\u5305\u62ec\u4ee5\u4e0b\u4e24\u79cd\u6a21\u5f0f\uff08\u89c1\u56fe2\uff09\uff0c\u4e00\u662fBRAF\u57fa\u56e0\u7a81\u53d8\u4f34\u968f\u9ad8\u5ea6 CIMP \u75c5\u53d8\u5411\u9ad8\u5ea6 MSI \u578b\u6216\u5fae\u536b\u661f\u7a33\u5b9aMSS\u578b\u7ed3\u76f4\u80a0\u764c\u53d1\u5c55\uff1b\u4e8c\u662f KRAS \u57fa\u56e0\u7a81\u53d8\u4f34\u968f\u4f4e\u5ea6CIMP\u6700\u7ec8\u5411MSS\u578b\u7ed3\u76f4\u80a0\u764c\u53d1\u5c55\u3002\u7b2c\u4e00\u79cd\u6a21\u5f0f\u4e0e\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u975e\u5e38\u76f8\u5173\uff0c\u8fd9\u79cd\u7ed3\u76f4\u80a0\u764c\u5f80\u5f80\u53d1\u6e90\u4e8e\u65e0\u8482\u952f\u9f7f\u72b6\u901a\u8def\uff0c\u5e76\u4e14\u5448\u73b0\u9ad8\u5ea6CIMP\u8868\u578b\u3002\u7b2c\u4e8c\u79cd\u6a21\u5f0f\u4e0e\u952f\u9f7f\u72b6\u764c\u53d8\u9014\u5f84\u7684\u76f8\u5173\u6027\u8f83\u524d\u8005\u5f31\uff0c\u8fd9\u79cd\u7ed3\u76f4\u80a0\u764c\u5f80\u5f80\u53d1\u6e90\u4e8e\u4f20\u7edf\u952f\u9f7f\u72b6\u901a\u8def[5]<\/sup>\u3002<\/p>\n

\u56fe2 \u4e24\u6761\u952f\u9f7f\u72b6\u901a\u8def\u5177\u4f53\u6d41\u7a0b\u793a\u610f\u56fe[6]<\/sup><\/p>\n

02<\/p>\n

\u952f\u9f7f\u72b6\u75c5\u53d8\u7684\u5206\u5b50\u7279\u5f81<\/p>\n

2.1<\/p>\n

RUNX3 \u57fa\u56e0<\/p>\n

RUNX3\u662f\u4e00\u79cd\u65b0\u53d1\u73b0\u7684\u6291\u764c\u57fa\u56e0\uff0c\u8be5\u57fa\u56e0\u901a\u8fc7\u8c03\u8282\u7ec6\u80de\u5468\u671f\u548c\u8bf1\u5bfc\u7ec6\u80de\u51cb\u4ea1\u5bf9\u80bf\u7624\u9020\u6210\u6291\u5236\u3002RUNX3 \u57fa\u56e0\u7684\u5931\u6d3b\u53ef\u80fd\u4f1a\u9020\u6210\u764c\u75c7\u7684\u53d1\u751f\u3002RUNX3\u80fd\u6307\u5bfcTGF-\u03b2\u4fe1\u53f7\u901a\u8def\u8fc7\u7a0b\uff0c\u901a\u8fc7\u6291\u5236\u7ec6\u80de\u589e\u751f\u3001\u4fc3\u8fdb\u7ec6\u80de\u51cb\u4ea1\uff0c\u5728CRC\u7684\u53d1\u751f\u53d1\u5c55\u8fc7\u7a0b\u4e2d\u626e\u6f14\u7740\u91cd\u8981\u89d2\u8272[7]<\/sup>\u3002Subramaniam\u7b49[8]<\/sup>\u901a\u8fc7\u6bd4\u8f83RUNX3\u572819\u4f8bHP\u300114\u4f8bTSA\u4e2d\u7684\u514d\u75ab\u7ec4\u5316\u8868\u8fbe\u53d1\u73b0\uff0cHP\u548cTSA\u4e2dRUNX3\u7684\u9633\u6027\u7387\u8f83\u6b63\u5e38\u7ed3\u80a0\u7ec4\u7ec7\u6709\u6240\u4e0b\u964d\u3002\u8d75\u5dcd\u7b49[9]<\/sup>\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cHP\u3001SSA\/P\u53caTSA\u4e2dRUNX3 \u9633\u6027\u8868\u8fbe\u7387\u5206\u522b\u4e3a74.7%\u300149.0%\u300140.5%\uff0c\u5728CRC\u4e2d\u4ec5\u670935.0%\u3002SSA\/P\u3001TSA\u53caCRCRUNX3\u9633\u6027\u8868\u8fbe\u7387\u660e\u663e\u4f4e\u4e8e\u6b63\u5e38\u80a0\u9ecf\u819c\u53caHP\uff0c\u5dee\u5f02\u6709\u7edf\u8ba1\u5b66\u610f\u4e49\uff08P<0.05\uff09\uff0c\u63d0\u793aRUNX3 \u57fa\u56e0\u4f5c\u4e3aTGF-\u03b2\u7ec6\u80de\u4fe1\u53f7\u8f6c\u5bfc\u901a\u8def\u4e0b\u6e38\u7684\u4e00\u4e2a\u91cd\u8981\u56e0\u5b50\uff0c\u5176\u53c2\u4e0e\u4e86TGF-\u03b2\u5bf9\u4e0a\u76ae\u7ec6\u80de\u751f\u957f\u7684\u8d1f\u6027\u8c03\u63a7\uff0cRUNX3\u57fa\u56e0\u7684\u8868\u8fbe\u4e0b\u8c03\u53ef\u80fd\u662f\u952f\u9f7f\u72b6\u75c5\u53d8\u53d1\u5c55\u4e3aCRC\u7684\u539f\u56e0\u4e4b\u4e00\u3002<\/p>\n

2.2<\/p>\n

p16\u57fa\u56e0<\/p>\n

p16\u662f\u4e00\u79cd\u6291\u764c\u57fa\u56e0\uff0c\u901a\u8fc7\u7ade\u4e89\u6027\u6291\u5236CDK4 \/CDK6\u4ecb\u5bfc\u7684Rb\u57fa\u56e0\u86cb\u767d\u4ea7\u7269\u7684\u78f7\u9178\u5316\u3002p16\u57fa\u56e0\u5931\u6d3b\u53ef\u4f7f\u7ec6\u80de\u751f\u957f\u5931\u53bb\u63a7\u5236\uff0c\u5bfc\u81f4\u80bf\u7624\u7684\u53d1\u751f\u53d1\u5c55\u3002\u6709\u7814\u7a76\u63d0\u793a\uff0cp16\u7532\u57fa\u5316\u662f\u8be5\u57fa\u56e0\u5931\u6d3b\u7684\u6700\u91cd\u8981\u673a\u5236\uff0c\u5e76\u4e14\u662f\u764c\u524d\u7684\u65e9\u671f\u6539\u53d8\u3002p16\u57fa\u56e0\u7532\u57fa\u5316\u53ef\u80fd\u5bfc\u81f4p16\u86cb\u767d\u8868\u8fbe\u4e0b\u8c03\uff0c\u4e0e\u952f\u9f7f\u72b6\u75c5\u53d8\u7684\u53d1\u751f\u3001\u53d1\u5c55\u5bc6\u5207\u76f8\u5173\uff0c\u5728\u952f\u9f7f\u72b6\u901a\u8def\u4e2d\u8d77\u63a8\u52a8\u4f5c\u7528\uff0c\u662f\u53d1\u751fCRC\u7684\u91cd\u8981\u5206\u5b50\u4e8b\u4ef6\u3002\u540c\u65f6\uff0cp16\u57fa\u56e0\u7532\u57fa\u5316\u53ef\u80fd\u4e0e\u5e74\u9f84\u76f8\u5173\uff0c\u968f\u5e74\u9f84\u589e\u957f\u7532\u57fa\u5316\u7a0b\u5ea6\u4e5f\u8d8a\u9891\u7e41[10]<\/sup>\u3002<\/p>\n

2.3<\/p>\n

 p53\u57fa\u56e0<\/p>\n

p53\u662f\u4e00\u79cd\u6291\u764c\u57fa\u56e0\uff0c\u5b9a\u4f4d\u4e8e17\u53f7\u67d3\u8272\u4f53\u7684\u77ed\u81c2\u4e0a\u3002p53\u57fa\u56e0\u7684\u4e3b\u8981\u529f\u80fd\u662f\u76d1\u89c6\u7ec6\u80de\u57fa\u56e0\u7ec4\u7684\u5b8c\u6574\u6027\uff0c\u7ef4\u6301\u7ec6\u80de\u7684\u6b63\u5e38\u589e\u6b96\uff0c\u4e00\u65e6\u7ec6\u80de\u7684\u57fa\u56e0\u88ab\u7834\u574f\uff0cp53\u5c31\u80fd\u4fee\u590d\u88ab\u7834\u574f\u7684\u57fa\u56e0\u3002\u4f46\u662f\uff0c\u5982\u679c p53\u81ea\u8eab\u53d1\u751f\u7a81\u53d8\uff0c\u5b83\u7684\u8fd9\u79cd\u6291\u5236\u764c\u7ec6\u80de\u7684\u529f\u80fd\u5c31\u4f1a\u4e27\u5931\uff0c\u4ece\u800c\u5bfc\u81f4\u7ec6\u80de\u53d1\u751f\u6076\u6027\u8f6c\u5316\u3002\u8d75\u5dcd\u7b49[9]<\/sup>\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u7a81\u53d8\u7684p53\u5728\u6b63\u5e38\u80a0\u9ecf\u819c\u4e2d\u8868\u8fbe\u9633\u6027\u7387\u4e3a21.7%\uff0c\u800cSSA\/P\u53caTSA\u7684\u9633\u6027\u8868\u8fbe\u7387\u9010\u6e10\u5347\u9ad8\uff0c\u8fbe47.9%\u300151.9%\uff0c\u5728CRC\u4e2d\u9633\u6027\u7387\u8fbe\u523060.0%\uff0c\u63d0\u793a\u7a81\u53d8\u578bp53\u53ef\u80fd\u53d1\u751f\u5728CRC\u7684\u65e9\u671f\uff0c\u4e0eCRC\u7684\u53d1\u751f\u76f8\u5173\u3002<\/p>\n

2.4<\/p>\n

MLH1\u7532\u57fa\u5316<\/p>\n

\u5728\u952f\u9f7f\u72b6\u764c\u53d8\u901a\u8def\u4e2d\uff0c\u9519\u914d\u4fee\u590d(MMR)\u57fa\u56e0\u8868\u8fbe\u7f3a\u5931\u53d1\u6325\u7740\u91cd\u8981\u7684\u4f5c\u7528\u3002\u9519\u914d\u4fee\u590d\u57fa\u56e0\u5305\u62ecMLH1\u3001MSH2\u3001MSH6\u3001PMS2\u7b49\uff0c\u5176\u4e2dMLH1\u53d1\u6325\u4e3b\u8981\u7684\u4f5c\u7528\u3002\u8fd1\u5e74\u6765\u5728\u7ed3\u76f4\u80a0\u764c\u4e2d\u5173\u4e8eMLH1\u7684\u7814\u7a76\u9010\u6e10\u5f00\u59cb\u589e\u591a\uff0c\u800c\u5728\u7ed3\u76f4\u80a0\u764c\u524d\u75c5\u53d8\u4e2d\u7684\u7814\u7a76\u5374\u5e76\u4e0d\u591a\u3002\u524d\u6587\u4e2dSSA\/P\u7684\u764c\u53d8\u901a\u8def\u663e\u793a\u7531BRAF\u57fa\u56e0\u7a81\u53d8\u548cMLH1\u57fa\u56e0\u7532\u57fa\u5316\u81f4\u9ad8\u5fae\u536b\u661f\u4e0d\u7a33\u5b9a(MSI-H)\u7ee7\u800c\u53d1\u5c55\u4e3a\u764c\u3002\u5468\u5fb7\u7965[11]<\/sup>\u7684\u7814\u7a76\u7ed3\u679c\u53d1\u73b0\u5728\u589e\u751f\u6027\u606f\u8089\u3001\u65e0\u8482\u952f\u9f7f\u72b6\u606f\u8089\u6216\u817a\u7624\u548c\u4f20\u7edf\u952f\u9f7f\u72b6\u817a\u7624\u7ec4\u7ec7\u4e2dMLH1\u8868\u8fbe\u7387\u5206\u522b\u4e3a97.4%\u300175.0%\u548c64.0%\uff08\u89c1\u88681\uff09\uff0c\u5448\u73b0\u51fa\u9010\u6e10\u964d\u4f4e\u7684\u8d8b\u52bf\uff0c\u6545\u63a8\u6d4bMLH1\u57fa\u56e0\u7684\u8868\u8fbe\u4e0e\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u764c\u53d8\u901a\u8def\u5177\u6709\u4e00\u5b9a\u7684\u76f8\u5173\u6027\uff0c\u968f\u7740\u764c\u53d8\u7a0b\u5ea6\u7684\u52a0\u5267\uff0cMLH1\u7f3a\u5931\u7387\u4f9d\u6b21\u9012\u589e\u3002<\/p>\n

\u88681 \u7ed3\u76f4\u80a0\u764c\u524d\u75c5\u53d8\u7ec4\u7ec7\u4e2d\u9519\u914d\u4fee\u590d\u57fa\u56e0MLH1\u7684\u86cb\u767d\u8868\u8fbe\u60c5\u51b5<\/p>\n

2.5<\/p>\n

MGMT\u7532\u57fa\u5316<\/p>\n

MGMT \u4e3a\u4e00\u79cdDNA\u635f\u4f24\u4fee\u590d\u57fa\u56e0\uff0c\u542f\u52a8\u5b50\u533a\u7532\u57fa\u5316\u53ef\u80fd\u662f\u57fa\u56e0\u5931\u6d3b\u7684\u91cd\u8981\u539f\u56e0\u3002\u8bb8\u6625\u4f1f\u7b49[12]<\/sup>\u901a\u8fc7\u57fa\u56e0\u5c42\u9762\u548c\u86cb\u767d\u5c42\u9762\u53ca\u4e24\u8005\u76f8\u5173\u6027\u7684\u63a2\u7a76\uff08\u89c1\u88682\u3001\u88683\uff09,\u63a8\u6d4b\u5728\u952f\u9f7f\u72b6\u75c5\u53d8\u901a\u8def\u4e2dMGMT\u57fa\u56e0\u542f\u52a8\u5b50\u7532\u57fa\u5316\u6709\u8bf1\u5bfcMGMT\u86cb\u767d\u8868\u8fbe\u4e0b\u8c03, \u4e0e\u952f\u9f7f\u72b6\u75c5\u53d8\u7684\u53d1\u751f\u3001\u53d1\u5c55\u5bc6\u5207\u76f8\u5173\uff0c\u5728\u65e0\u8482(\u5e7f\u57fa)\u952f\u9f7f\u901a\u8def\u548c\u4f20\u7edf\u952f\u9f7f\u72b6\u901a\u8def\u4e2d\u8d77\u91cd\u8981\u63a8\u52a8\u4f5c\u7528\uff0c\u662fCRC\u53d1\u751f\u91cd\u8981\u7684\u5206\u5b50\u4e8b\u4ef6\u3002<\/p>\n

\u88682  MGMT\u57fa\u56e0CpG\u5c9b\u7532\u57fa\u5316\u9633\u6027\u7387\u7edf\u8ba1\u7ed3\u679c [n(%)]<\/p>\n

\u88683  MGMT\u86cb\u767d\u8868\u8fbe\u9633\u6027\u7387\u7edf\u8ba1\u7ed3\u679c [n(%)]<\/p>\n

2.6<\/p>\n

Ki-67<\/p>\n

ki-67\u86cb\u767d\u5b58\u5728\u4e8e\u589e\u6b96\u671f\u7ec6\u80de\u4e2d\uff0c\u5448\u7ec6\u80de\u6838\u8868\u8fbe\u7684\u86cb\u767d\uff0c\u4e0e\u7ec6\u80de\u7684\u5408\u6210\u4ee3\u8c22\u5bc6\u5207\u76f8\u5173\uff0c\u7531\u4e8eki-67\u8f83\u77ed\u7684\u534a\u8870\u671f\uff0c\u5f53\u5b83\u8131\u79bb\u7ec6\u80de\u5468\u671f\u540e\u4f1a\u8fc5\u901f\u964d\u89e3\uff0c\u6240\u4ee5\u5bf9Ki-67\u8868\u8fbe\u6c34\u5e73\u7684\u68c0\u6d4b\u6210\u4e3a\u68c0\u6d4b\u80bf\u7624\u7ec6\u80de\u589e\u6b96\u7387\u7684\u53ef\u9760\u6307\u6807\u4e4b\u4e00\uff0c\u5bf9\u8bc4\u4ef7\u7ec6\u80de\u7684\u589e\u6b96\u72b6\u6001\u3001\u80bf\u7624\u7684\u751f\u7269\u5b66\u884c\u4e3a\u3001\u8861\u91cf\u80bf\u7624\u5371\u5bb3\u6027\u5177\u6709\u91cd\u8981\u4f5c\u7528\uff0c\u65e9\u5df2\u5e7f\u6cdb\u5e94\u7528\u4e8e\u4e34\u5e8a\u8bca\u65ad\u53ca\u79d1\u5b66\u7814\u7a76\u3002\u65b9\u56ed\u7b49[7]<\/sup>\u7814\u7a76\u663e\u793a\uff0c52\u4f8bHP\u4e2d\uff0c\u9633\u6027\u6307\u6570\u4e3a26%-50% 15\u4f8b\uff0c\uff1e50% 21\u4f8b\uff1b\u9633\u6027\u90e8\u4f4d\u4f4d\u4e8e\u4fa7\u97629\u4f8b\uff0c\u5f25\u6f2b 12\u4f8b\u3002\u4e0eSSA\u3001TSA\u548cCRC\u76f8\u6bd4\uff0cHP\u7684\u5f02\u5e38\u9633\u6027\u8868\u8fbe\u51cf\u5c11\uff0c\u5dee\u5f02\u663e\u8457( P\uff1c0.05)\u3002\u800c\u5728HP\u7684\u5206\u578b\u4e2d\uff0cMPHP\uff08\u9ecf\u6db2\u7f3a\u4e4f\u578bHP\uff09\u7684\u5f02\u5e38\u8868\u8fbe\u8f83\u591a\u3002\u63d0\u793aMPHP\u589e\u6b96\u6d3b\u6027\u8f83\u9ad8\uff0c\u53ef\u80fd\u5177\u6709\u4e00\u5b9a\u7684\u6076\u6027\u6f5c\u80fd\u3002<\/p>\n

\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u4e0e\u7ed3\u76f4\u80a0\u764c\u5173\u7cfb\u5bc6\u5207\uff0c\u7ea615%-30%\u7684\u7ed3\u76f4\u80a0\u764c\u6765\u81ea\u952f\u9f7f\u72b6\u901a\u8def\u3002\u4e00\u9879\u4e39\u9ea6\u7684\u7814\u7a76[13]<\/sup>\uff0c\u5171\u7eb3\u5165272342\u540d\u63a5\u53d7\u80a0\u955c\u68c0\u67e5\u7684\u4e2a\u4f53\uff0c\u5305\u62ec2045\u4f8bCRC\u75c5\u4f8b\uff0c\u53d1\u73b0SSA\/P\u6216TSA\u60a3\u8005CRC\u53d1\u751f\u98ce\u9669\u589e\u52a0\uff0c\u4e0e\u4f20\u7edf\u817a\u7624\u76f8\u5f53\u751a\u81f3\u66f4\u9ad8\u3002Schreiner\u7b49[14]<\/sup>\u5bf93121\u4f8b\u63a5\u53d7\u80a0\u955c\u7b5b\u67e5\u7684\u65e0\u75c7\u72b6\u60a3\u8005\u7814\u7a76\u540e\u53d1\u73b0\uff0c\u90a3\u4e9b\u5177\u6709\u5927\u7684\u8fd1\u7aefCSL\u7684\u60a3\u8005\u53d1\u751f\u540c\u65f6\u6027\u8fdb\u5c55\u671f\u817a\u7624\u7684\u53ef\u80fd\u6027\u66f4\u5927\uff08OR 3.37,95% CI 1.71-6.65\uff09\u3002\u56e0\u6b64\uff0c\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u7684\u65e9\u671f\u7b5b\u67e5\u4e0e\u8bca\u65ad\u975e\u5e38\u91cd\u8981\u3002\u76ee\u524d\uff0c\u7ed3\u80a0\u955c\u68c0\u67e5\uff08\u7ed3\u5408\u75c5\u7406\u68c0\u67e5\uff09\u662fCRC\u7b5b\u67e5\u3001\u8bca\u65ad\u548c\u968f\u8bbf\u7684\u91d1\u6807\u51c6\uff0c\u4e5f\u662f\u6cbb\u7597\u7ed3\u80a0\u75c5\u53d8\u7684\u91cd\u8981\u624b\u6bb5\uff0c\u7ed3\u80a0\u955c\u68c0\u67e5\u53ca\u75c5\u53d8\u5207\u9664\u53ef\u4f7fCRC\u7684\u53d1\u75c5\u7387\u964d\u4f4e76%-90%\uff0c\u6b7b\u4ea1\u7387\u964d\u4f4e53%\u3002\u4f46\u662f\u7ed3\u80a0\u955c\u4e0d\u80fd\u9884\u9632\u7ed3\u80a0\u95f4\u671f\u764c\u7684\u53d1\u751f\uff0c\u5176\u4e2d\u6700\u91cd\u8981\u7684\u539f\u56e0\u662f\u7ed3\u80a0\u75c5\u53d8\u7684\u6f0f\u8bca[2]<\/sup>\u3002\u5185\u955c\u533b\u5e08\u5fc5\u987b\u5145\u5206\u8ba4\u8bc6\u6b64\u7c7b\u75c5\u53d8\uff0c\u75c5\u7406\u533b\u5e08\u4e0e\u4e4b\u914d\u5408\uff0c\u7ed3\u5408\u8fd9\u6761\u75c5\u53d8\u901a\u8def\u4e0a\u5206\u5b50\u6c34\u5e73\u4e0e\u7ec4\u5316\u6297\u4f53\u7684\u53d8\u5316\u7279\u5f81\uff0c\u4ece\u800c\u63d0\u9ad8\u5176\u68c0\u51fa\u7387\u5e76\u4e88\u4ee5\u5207\u9664\u3002\u540c\u65f6\u63d0\u9ad8\u516c\u4f17\u5bf9\u4e8eCRC\u7684\u77e5\u6653\u5ea6\uff0c\u5145\u5206\u4e86\u89e3CRC\u53ca\u764c\u524d\u75c5\u53d8\u7684\u5371\u5bb3\uff0c\u9ad8\u5ea6\u91cd\u89c6\u65e9\u671f\u5e72\u9884\u7684\u5fc5\u8981\u6027\u548c\u91cd\u8981\u6027\uff0c\u6709\u6548\u63a8\u8fdbCRC\u65e9\u8bca\u65e9\u6cbb\u7684\u5b9e\u9645\u843d\u5730\u3002<\/p>\n

\u53c2\u8003\u6587\u732e <\u4e0a\u4e0b\u6ed1\u52a8\u9884\u89c8><\/p>\n

[1] Latest global cancer data: Cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020. Retrieved Dec 16, 2020, from https:\/\/www.\/fr\/news-events\/latest-global-cancer-data-cancer-burden-rises-to-19-3-million-new-cases-and-10-0-million-cancer-deaths-in-2020\/<\/p>\n

[2]\u56fd\u5bb6\u6d88\u5316\u7cfb\u7edf\u75be\u75c5\u4e34\u5e8a\u533b\u5b66\u4e2d\u5fc3\uff08\u4e0a\u6d77\uff09\uff0c\u4e2d\u534e\u533b\u5b66\u4f1a\u6d88\u5316\u5185\u955c\u5b66\u5206\u4f1a\uff0c\u4e2d\u56fd\u6297\u764c\u534f\u4f1a\u80bf\u7624\u5185\u955c\u4e13\u4e1a\u59d4\u5458\u4f1a\uff0c\u7b49.\u4e2d\u56fd\u7ed3\u76f4\u80a0\u764c\u764c\u524d\u75c5\u53d8\u548c\u764c\u524d\u72b6\u6001\u5904\u7406\u7b56\u7565\u4e13\u5bb6\u5171\u8bc6[J].\u4e2d\u534e\u6d88\u5316\u5185\u955c\u6742\u5fd7\uff0c2022\uff0c39\uff081\uff09\uff1a1-18.<\/p>\n

[3] \u6768\u7384.\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u7684\u7814\u7a76\u8fdb\u5c55[J].\u73b0\u4ee3\u6d88\u5316\u53ca\u4ecb\u5165\u8bca\u7597\uff0c2022\uff0c27(5)\uff1a652-657.<\/p>\n

[4]Bettington M, Walker N, Clouston A, et al. The serrated pathway to colorectal carcinoma: current concepts and challenges. Histopathology, 2013, 62(3): 367-86<\/p>\n

[5]Jass JR. Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology, 2007, 50(1): 113-30<\/p>\n

[6] \u5468\u667a\u52c7. \u6563\u53d1\u6027\u7ed3\u76f4\u80a0\u764c\u4f20\u7edf\u578b\u952f\u9f7f\u72b6\u53d1\u751f\u901a\u8def\u7684\u90e8\u5206\u4e34\u5e8a\u7279\u5f81\u53ca\u5206\u5b50\u6539\u53d8\u7684\u7814\u7a76. \u4e2d\u56fd\u4eba\u6c11\u89e3\u653e\u519b\u603b\u533b\u9662,2008.<\/p>\n

[7]\u65b9\u56ed. \u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u606f\u8089\u7684\u4e34\u5e8a\u75c5\u7406\u53ca7\u79cd\u6297\u4f53\u8868\u8fbe[J]. Diag Pathol,April 2013,Vol.20,No.4.<\/p>\n

[8] Subramaniam MM\uff0cChan YJ\uff0cSoong R\uff0cet al\uff0eRUNX3 inactivation in colorectal polyps arising through different pathways of colonic carcinogenesis[J].Am J Gastroenterol\uff0c2009\uff0c104 (2): 426-436\uff0e<\/p>\n

[9] \u8d75\u5dcd. RUNX3\u548cp53\u5728\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u53ca\u7ed3\u76f4\u80a0\u764c\u7ec4\u7ec7\u4e2d\u7684\u8868\u8fbe\u53ca\u610f\u4e49[J].\u4e2d\u56fd\u5f53\u4ee3\u533b\u836f\uff0c2019\uff0c26\uff0820\uff09\uff1a40-43.<\/p>\n

[10]\u845b\u7545. \u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u4e2dp16\u57fa\u56e0\u7532\u57fa\u5316\u72b6\u6001\u548c\u86cb\u767d\u8868\u8fbe\u7684\u7814\u7a76[J].\u8bca\u65ad\u75c5\u7406\u5b66\u6742\u5fd7\uff0c2014\uff0c21(3)\uff1a169-175.<\/p>\n

[11] \u5468\u5fb7\u7965. MLH1\u548cCK20\u5728\u7ed3\u76f4\u80a0\u764c\u524d\u75c5\u53d8\u4e0e\u7ed3\u76f4\u80a0\u764c\u4e2d\u7684\u8868\u8fbe\u53ca\u4e34\u5e8a\u610f\u4e49[J]. JOURNAL OF RARE AND UNCOMMON DISEASES, OCT. 2021,Vol.28, No.5, Total No.148.<\/p>\n

[12] \u8bb8\u6625\u4f1f. MGMT\u57fa\u56e0\u7532\u57fa\u5316\u72b6\u6001\u5728\u7ed3\u76f4\u80a0\u952f\u9f7f\u72b6\u75c5\u53d8\u4e2d\u7684\u8868\u8fbe\u53ca\u610f\u4e49[J].\u4e2d\u56fd\u533b\u836f\u5bfc\u62a5\uff0c2014\uff0c11(2)\uff1a11-17.<\/p>\n

[13]Erichsen R,Baron JA,Hamilton-Dutoit SJ,et al.Increased Risk of Colorectal Cancer Development Among Patients With Serrated Polyps[J].Gastroenterology,2016,150\uff084\uff09:895-902.<\/p>\n

[14]Schreiner MA,Weiss DG,Lieberman DA.Proximal and large hyperplastic and nondysplastic serra-ted polyps detected by colonoscopy are associated with neoplasis[J].Gastroenterology,2010,139\uff085\uff09\uff1a1497-1502.<\/p>\n

END <\/p>\n

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