Kaya Mustafa, Basak Fatih, Sisik Abdullah, Hasbahceci Mustafa, Bas Gurhan, Alimoglu Orhan, Topal Cumhur Selçuk, Kir Gozde
Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey.
Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
J Cancer Res Ther. 2017 Apr-Jun;13(2):356-361. doi: 10.4103/0973-1482.174558.
Hereditary nonpolyposis colorectal cancer (HNPCC) is a subgroup of colorectal cancer (CRC) which should be differentiated because of the high risk for additional cancers and risk evaluation for other family members, especially for CRC. It is not practical to perform genetic testing for all CRC patients; therefore, various prediction modalities, for example, Bethesda guideline (BG) were studied in the literature. We aimed to assess the association of microsatellite instability (MSI), histology scores, and BG for predicting HNPCC risk.
Data were collected from CRC patients between 2009 and 2012. A total of 127 patients were retrospectively reviewed for BG status and the MSI scores, MsPath, and PathScore.
Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data. Comparison used Student's t-test, Continuity (Yates) correction, Fisher-Freeman-Halton test, Pearson correlation, and receiver operating characteristics curve analysis.
Patients who were detected as Bethesda-positive had significantly higher MsPath and PathScore scores (P = 0.001 and P = 0.007, respectively). According to the cut-off value of 2.8 and 2.9 for MsPath and PathScore, respectively, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90%, 43%, 22.8%, 95.8%, and 50.4% for MsPath, and 55%, 83.2%, 37.9%, 90.8%, and 78.7% for PathScore, respectively.
The MSI scoring systems, MsPath, and PathScore, are reliable systems and effectively correlated with BG for predicting patients who need advanced analysis techniques because of the risk of HNPCC.
遗传性非息肉病性结直肠癌（HNPCC）是结直肠癌（CRC）的一个亚组，因其发生其他癌症的风险高以及对其他家庭成员（尤其是CRC）的风险评估，需要加以区分。对所有CRC患者进行基因检测并不实际；因此，文献中研究了各种预测方法，例如贝塞斯达指南（BG）。我们旨在评估微卫星不稳定性（MSI）、组织学评分和BG与预测HNPCC风险之间的关联。
收集2009年至2012年期间CRC患者的数据。对127例患者进行回顾性分析，评估其BG状态以及MSI评分、MsPath和PathScore。
使用确定性统计方法（均值、标准差、中位数、频数和百分比）评估研究数据。比较采用学生t检验、连续性（耶茨）校正、费舍尔 - 弗里曼 - 霍尔登检验、皮尔逊相关性分析以及受试者工作特征曲线分析。
被检测为贝塞斯达阳性的患者MsPath和PathScore评分显著更高（分别为P = 0.001和P = 0.007）。根据MsPath和PathScore的截断值分别为2.8和2.9，MsPath的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为90%、43%、22.8%、95.8%和50.4%，PathScore的分别为55%、83.2%、37.9%、90.8%和78.7%。
MSI评分系统MsPath和PathScore是可靠的系统，并且与BG有效相关，可用于预测因HNPCC风险而需要先进分析技术的患者。
