Comparison of Microsatellite Instability With Clinicopathologic Data in Patients With Colon Adenocarcinoma

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Apr 9

PMID 38590982

Authors

Emine Cesmecioglu Karavin

Zeynep Sagnak Yilmaz

Hilmi Yazici

Safak Ersoz

Sevdegul Mungan

Affiliations

Soon will be listed here.

Abstract

Background Microsatellite instability (MSI) is a genetic condition caused by errors in DNA repair genes that cause colorectal cancer (CRC). The literature contradicts the frequency of MSI in sporadic CRCs and its effect on prognosis. This study investigated the distribution of clinicopathologic features and the relationship between MSI and survival outcomes. Methodology This is a retrospective study of 101 consecutive cases of CRC and immunohistochemical studies. All cases were retrospectively reviewed and reevaluated by histological grade, lymphovascular invasion, perineural invasion, tumor borders, dirty necrosis, tumor-infiltrating lymphocytes (TILs), Crohn's-like lymphoid reaction, mucinous and medullary differentiation, and tumoral budding from pathological slides. An immunohistochemical study was performed in appropriate blocks for using MLH-1, MSH-2, MSH-6, and PMS-2. We collected the clinical stage, pathological tumor stage, lymph node metastasis, age, sex, tumor diameter, distant metastasis, localization, and survival information from patients' clinical data. Results There was no statistically significant difference between the two groups regarding age, gender, tumor diameter, histological grade, tumor border, dirty necrosis, TILs, N and M stage, perineural and lymphovascular invasion, mucinous differentiation, medullary differentiation, and tumor budding characteristics of the patients. The MSI-H group was more frequently located in the right colon and transverse colon (p < 0.001), and the T stage was higher among them than in the MSI-L group (p = 0.014). Upon multivariate regression analysis, MSI status had no significant effect on survival time. Age and stage N and M were independent prognostic factors for colon cancer prognosis. Conclusions Our study presented the distribution of clinicopathological features and their relationship with MSI for 101 regional CRC patients. MSI status was detected by immunohistochemistry. Identifying MSI in CRCs may help personalize therapy planning. As the distribution of the features may vary from population to population, further investigations are needed on this topic.

References

Nagtegaal I, Odze R, Klimstra D, Paradis V, Rugge M, Schirmacher P . The 2019 WHO classification of tumours of the digestive system. Histopathology. 2019; 76(2):182-188. PMC: 7003895. DOI: 10.1111/his.13975. View

Lugli A, Vlajnic T, Giger O, Karamitopoulou E, Patsouris E, Peros G . Intratumoral budding as a potential parameter of tumor progression in mismatch repair-proficient and mismatch repair-deficient colorectal cancer patients. Hum Pathol. 2011; 42(12):1833-40. DOI: 10.1016/j.humpath.2011.02.010. View

Ueno H, Hashiguchi Y, Shimazaki H, Shinto E, Kajiwara Y, Nakanishi K . Objective criteria for crohn-like lymphoid reaction in colorectal cancer. Am J Clin Pathol. 2013; 139(4):434-41. DOI: 10.1309/AJCPWHUEFTGBWKE4. View

Shia J, Stadler Z, Weiser M, Rentz M, Gonen M, Tang L . Immunohistochemical staining for DNA mismatch repair proteins in intestinal tract carcinoma: how reliable are biopsy samples?. Am J Surg Pathol. 2011; 35(3):447-54. DOI: 10.1097/PAS.0b013e31820a091d. View

Lanza G, Gafa R, Maestri I, Santini A, Matteuzzi M, Cavazzini L . Immunohistochemical pattern of MLH1/MSH2 expression is related to clinical and pathological features in colorectal adenocarcinomas with microsatellite instability. Mod Pathol. 2002; 15(7):741-9. DOI: 10.1097/01.MP.0000018979.68686.B2. View

Zumstein V, Vinzens F, Zettl A, Heinimann K, Koeberle D, von Flue M . Systematic immunohistochemical screening for Lynch syndrome in colorectal cancer: a single centre experience of 486 patients. Swiss Med Wkly. 2016; 146:w14315. DOI: 10.4414/smw.2016.14315. View

Wright C, Stewart I . Histopathology and mismatch repair status of 458 consecutive colorectal carcinomas. Am J Surg Pathol. 2003; 27(11):1393-406. DOI: 10.1097/00000478-200311000-00001. View

Alexander J, Watanabe T, Wu T, Rashid A, Li S, Hamilton S . Histopathological identification of colon cancer with microsatellite instability. Am J Pathol. 2001; 158(2):527-35. PMC: 1850324. DOI: 10.1016/S0002-9440(10)63994-6. View

Gafa R, Maestri I, Matteuzzi M, Santini A, Ferretti S, Cavazzini L . Sporadic colorectal adenocarcinomas with high-frequency microsatellite instability. Cancer. 2000; 89(10):2025-37. View

10.

Smyrk T, Watson P, Kaul K, Lynch H . Tumor-infiltrating lymphocytes are a marker for microsatellite instability in colorectal carcinoma. Cancer. 2001; 91(12):2417-22. View

11.

Malik A, Kaur Bhatia J, Sahai K, Boruah D, Sharma A . Evaluating morphological features for predicting microsatellite instability status in colorectal cancer. Med J Armed Forces India. 2022; 78(Suppl 1):S96-S104. PMC: 9485851. DOI: 10.1016/j.mjafi.2021.03.024. View

12.

Nayak S, Roy P, Arora N, Arun I, Roy M, Banerjee S . Prevalence estimation of microsatellite instability in colorectal cancers using tissue microarray based methods - A tertiary care center experience. Indian J Pathol Microbiol. 2018; 61(4):520-525. DOI: 10.4103/IJPM.IJPM_430_17. View

13.

Wang C, Zhang H, Liu Y, Wang Y, Hu H, Wang G . Molecular subtyping in colorectal cancer: A bridge to personalized therapy (Review). Oncol Lett. 2023; 25(6):230. PMC: 10157608. DOI: 10.3892/ol.2023.13816. View

14.

Carethers J, Smith E, Behling C, Nguyen L, Tajima A, Doctolero R . Use of 5-fluorouracil and survival in patients with microsatellite-unstable colorectal cancer. Gastroenterology. 2004; 126(2):394-401. DOI: 10.1053/j.gastro.2003.12.023. View

15.

Lamberti C, Kruse R, Ruelfs C, Caspari R, Wang Y, Jungck M . Microsatellite instability-a useful diagnostic tool to select patients at high risk for hereditary non-polyposis colorectal cancer: a study in different groups of patients with colorectal cancer. Gut. 1999; 44(6):839-43. PMC: 1727554. DOI: 10.1136/gut.44.6.839. View

16.

Michailidi C, Papavassiliou A, Troungos C . DNA repair mechanisms in colorectal carcinogenesis. Curr Mol Med. 2011; 12(3):237-46. DOI: 10.2174/156652412799218859. View

17.

Halvarsson B, Anderson H, Domanska K, Lindmark G, Nilbert M . Clinicopathologic factors identify sporadic mismatch repair-defective colon cancers. Am J Clin Pathol. 2008; 129(2):238-44. DOI: 10.1309/0PP5GDRTXUDVKAWJ. View

18.

Hampel H, Frankel W, Martin E, Arnold M, Khanduja K, Kuebler P . Feasibility of screening for Lynch syndrome among patients with colorectal cancer. J Clin Oncol. 2008; 26(35):5783-8. PMC: 2645108. DOI: 10.1200/JCO.2008.17.5950. View

19.

Greenson J, Huang S, Herron C, Moreno V, Bonner J, Tomsho L . Pathologic predictors of microsatellite instability in colorectal cancer. Am J Surg Pathol. 2008; 33(1):126-33. PMC: 3500028. DOI: 10.1097/PAS.0b013e31817ec2b1. View

20.

Nguyen L, Goel A, Chung D . Pathways of Colorectal Carcinogenesis. Gastroenterology. 2019; 158(2):291-302. PMC: 6981255. DOI: 10.1053/j.gastro.2019.08.059. View