Cesmecioglu Karavin Emine, Sağnak Yılmaz Zeynep, Yazici Hilmi, Ersoz Safak, Mungan Sevdegul
Pathology, Marmara University Pendik Training and Research Hospital, Istanbul, TUR.
Pathology, Karadeniz Technical University Faculty of Medicine, Trabzon, TUR.
Cureus. 2024 Apr 8;16(4):e57814. doi: 10.7759/cureus.57814. eCollection 2024 Apr.
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.
微卫星不稳定性(MSI)是一种由DNA修复基因错误导致的遗传状况,可引发结直肠癌(CRC)。文献中关于散发性结直肠癌中MSI的频率及其对预后的影响存在矛盾观点。本研究调查了临床病理特征的分布情况以及MSI与生存结局之间的关系。
这是一项对101例连续的结直肠癌病例进行的回顾性研究及免疫组织化学研究。所有病例均通过组织学分级、淋巴管浸润、神经周围浸润、肿瘤边界、脏层坏死、肿瘤浸润淋巴细胞(TILs)、克罗恩样淋巴反应、黏液和髓样分化以及病理切片中的肿瘤芽生进行回顾性审查和重新评估。在合适的组织块上进行免疫组织化学研究,以检测MLH-1、MSH-2、MSH-6和PMS-2。我们从患者的临床资料中收集了临床分期、病理肿瘤分期、淋巴结转移、年龄、性别、肿瘤直径、远处转移、定位和生存信息。
两组在患者的年龄、性别、肿瘤直径、组织学分级、肿瘤边界、脏层坏死、TILs、N和M分期、神经周围和淋巴管浸润、黏液分化、髓样分化以及肿瘤芽生特征方面无统计学显著差异。MSI-H组更常位于右半结肠和横结肠(p < 0.001),且其T分期高于MSI-L组(p = 0.014)。多因素回归分析显示,MSI状态对生存时间无显著影响。年龄以及N和M分期是结肠癌预后的独立预后因素。
我们的研究展示了101例局部结直肠癌患者的临床病理特征分布及其与MSI的关系。通过免疫组织化学检测MSI状态。在结直肠癌中识别MSI可能有助于个性化治疗方案的制定。由于这些特征的分布可能因人群而异,因此需要对该主题进行进一步研究。