Background/Objectives: Metabolic syndrome (MS) impacts 25% of the adult population worldwide and elevates the risk of colorectal cancer by 40%. Microsatellite instability (MSI) resulting from impaired DNA mismatch repair serves as a critical biomarker for selecting patients for immunotherapy. Methods: This single-center pilot study examined the correlations between MS and MSI in 157 individuals with surgically treated colorectal cancer. Patients were categorized according to the International Diabetes Federation Metabolic Syndrome criteria. The MSI status was assessed using immunohistochemical investigation of mismatch repair proteins. The statistical analysis encompassed chi-square tests and the computation of odds ratios. Results: Patients with MS exhibited a substantially greater prevalence of MSI compared to controls (15.5% vs. 9.8%,p< 0.05) corresponding to a 1.63-fold increase in odds. The co-occurrence of MSI and hepatic steatosis displayed a strong association within the MS group (OR: 5.81), indicating a 2.6-fold increased prevalence relative to controls. Conclusions: This pilot investigation offers initial evidence associating MS with a heightened frequency of MSI in colorectal cancer. The strong association with hepatic steatosis indicates common metabolic-genomic pathways. The findings advocate for the incorporation of metabolic assessment into precision oncology for the selection of immunotherapy, necessitating multicenter validation studies.
背景/目的：代谢综合征（MS）影响全球25%的成年人口，并使结直肠癌风险增加40%。由DNA错配修复功能缺陷引起的微卫星不稳定性（MSI）是筛选免疫治疗患者的关键生物标志物。方法：本单中心初步研究在157例接受手术治疗的结直肠癌患者中探讨了MS与MSI之间的相关性。患者根据国际糖尿病联盟代谢综合征标准进行分类。通过错配修复蛋白的免疫组化检测评估MSI状态。统计分析包括卡方检验和比值比计算。结果：与对照组相比，MS患者中MSI的患病率显著更高（15.5% vs. 9.8%，p < 0.05），对应的比值比为1.63。在MS组中，MSI与肝脂肪变性共存显示出强相关性（OR: 5.81），表明其患病率较对照组增加2.6倍。结论：本初步研究提供了初步证据，表明MS与结直肠癌中MSI发生率升高相关。其与肝脂肪变性的强关联提示了共同的代谢-基因组通路。研究结果支持将代谢评估纳入精准肿瘤学以指导免疫治疗选择，但需进行多中心验证研究。
Metabolic Syndrome Fuels Genomic Instability? Insights from a Pilot Study on Colorectal Cancer
肿瘤(癌症)患者之家