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Microsatellite instability status does not predict total lymph node or negative lymph node retrieval in stage III
Erin MacQuarrie1, Thomas Arnason, Jennette Gruchy
1Division of Anatomical Pathology, Department of Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada B3H 1V8.
Human Pathology
|February 7, 2012
Summary
Higher lymph node counts in colorectal cancer are linked to better survival. This study found microsatellite instability in stage III colon cancer did not correlate with more lymph nodes retrieved, suggesting other factors drive improved survival.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Pathology
Background:
- Higher total lymph node count in colorectal cancer is associated with improved overall survival.
- Recent studies suggest a link between microsatellite instability (MSI) and increased lymph node retrieval in colorectal cancer.
- The potential impact of MSI status on lymph node yield requires further investigation.
Purpose of the Study:
- To validate the association between microsatellite instability and lymph node retrieval in stage III colon cancer.
- To determine if MSI status influences the total number of lymph nodes or the number of negative lymph nodes examined.
- To explore the relationship between MSI status and overall survival in stage III colon cancer.
Main Methods:
- Retrospective review of 168 stage III colon cancer resection specimens.
- Immunohistochemistry to assess DNA mismatch repair protein expression.
- Polymerase chain reaction to determine microsatellite instability status.
Main Results:
- No significant difference in mean total lymph node count between MSI and microsatellite stable (MSS) tumors (15.9 vs. 16.9, P = .664).
- No significant difference in mean negative lymph node count between MSI and MSS tumors (12.2 vs. 13.6, P = .522).
- Microsatellite instability was associated with improved overall survival (P = .026), independent of lymph node retrieval.
Conclusions:
- This study does not support a significant relationship between microsatellite status and higher lymph node retrieval in stage III colon cancer.
- The improved survival observed in MSI-high colon cancers is likely not attributable to increased lymph node yield.
- Further research is needed to elucidate the mechanisms underlying improved survival in MSI-high colorectal cancers.
