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目的:探讨肿瘤突变负荷（TMB）在术后接受卡培他滨为基础辅助化疗的结直肠癌（CRC）患者中的临床意义。方法:本研究纳入82例接受Rn 0手术切除并且术后接受卡培他滨为基础辅助化疗的CRC患者，提取癌组织标本DNA，通过肿瘤相关基因的二代测序技术（NGS）进行体细胞突变检测和TMB分析。TMB状态与预后的单变量分析采用Kaplan-Meier生存分析方法，并通过多变量COX风险比例模型进行校正。n 结果:本组82例接受卡培他滨为基础辅助化疗的CRC患者的中位随访时间为5.5年，中位无疾病生存期（DFS）为4.5年，中位总生存期（OS）为5.7年。NGS分析结果表明，82例患者中最常见的突变基因为TP53、APC、KRAS、PIK3CA，突变频率分别为68.3%、64.6%、46.3%、29.3%，其他体细胞突变基因频率相对较低（3.6/Mb），两组患者分别有42例和40例，TMB-H组患者和TMB-L组患者的中位OS分别为4.7年和6.5年，差异具有统计学意义（χn 2=6.59，n P=0.010）。多变量COX风险比例模型结果提示TMB-H是患者OS的独立危险因素（n HR=0.73，n P=0.021）。n 结论:TMB可以考虑作为评估Rn 0切除术后接受卡培他滨为基础辅助化疗CRC患者预后的生物标志物。n “,”Objective:To investigate the clinical significance of TMB among CRC patients after Rn 0 resection and capecitabine-based adjuvant chemotherapy.n Methods:Data of 82 CRC patients were reviewed retrospectively. Tumor tissue specimens were collected for DNA extraction . Somatic mutation detection and TMB analysis were performed using next-generation sequencing (NGS) of tumor-related genes. The univariate analysis between TMB status and prognosis was carried out by Kaplan-Meier survival analysis and adjusted by multivariate COX regression analysis subsequently.Results:In these 82 cases,with the median follow-up period was 5.5 years the median disease-free survival (DFS) was 4.5 years, and the median overall survival (OS) was 5.7 years. The most common mutated somatic genes were TP53, APC, KRAS and PIK3CA, with the mutation frequencies of 68.3%, 64.6%, 46.3% and 29.3%, respectively. Other somatic mutant genes were of a relatively low frequency (3.6/Mb) according to the median TMB threshold. And the patients with TMB-L and TMB-H were 42 cases and 40 cases, respectively. The median OS in patients with TMB-L and TMB-H was 6.5 and 4.7 years, respectively (χn 2=6.59, n P=0.010). TMB status was an independent factor for OS (n HR=0.73, n P=0.021).n Conclusion:TMB is a biomarker for evaluating the prognosis of CRC patients after surgical resection and receiving capecitabine-based adjuvant chemotherapy .