近年来,免疫检查点阻断疗法已成为革命性的癌症治疗方法。尤其在高突变负担的瘤种中,抗PD-1 / PD-L1、抗CTLA-4可增强T细胞介导的免疫反应,给肿瘤患者带来确切获益。
该研究共纳入208例荷兰籍(NL)与45例法国籍(FR)结直肠癌患者。在FR组,应用免疫组织化学方法检测MMR蛋白(MLH1,MSH2,MSH6、PMS2)的表达缺失情况,使用五个单核苷酸位点(BAT-25、BAT-26、NR-21、NR-24、NR-27)检测微卫星不稳定性(MSI),且dMMR是指三个及以上的位点不稳定。
在NL组,使用肿瘤MSI分析系统检确定MMR状态。在研究队列中,有20%的样本因无法进行DNA分析,而采用免疫组化法检测PMS2与MSH6,若发现免疫检测异常,则继续检测MLH1与MSH2。大多FR组样本(n=40)可获得RNA表达与共识分子分型(CMS)分类数据。
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