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Related Concept Videos

Multiple Comparison Tests01:13

Multiple Comparison Tests

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Multiple comparison test, abbreviated as MCT, is a post hoc analysis generally performed after comparing multiple samples with one or more tests. An MCT will help identify a significantly different sample among multiple samples or a factor among multiple factors.
It would be easy to compare two samples using a significance alpha level of 0.05. In other words, there is only one sample pair to be compared. However, it would be difficult to identify a significantly different sample if the number...
4.1K

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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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MSI testing : What's new? What should be considered?

Josef Rüschoff1, Gustavo Baretton2, Hendrik Bläker3

  • 1Institute of Pathology, Nordhessen und Targos Molecular Pathology GmbH, Germaniastr. 7, 34119, Kassel, Germany. josef.rueschoff@targos-gmbh.de.

Der Pathologe
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Summary

Detecting high-grade microsatellite instability (MSI-H) or deficient mismatch repair (dMMR) is crucial for predicting immune checkpoint inhibitor (ICI) treatment response. A new algorithm aids reliable and cost-effective MSI-H/dMMR testing in routine diagnostics.

Keywords:
DNA mismatch repairEndometrial carcinomaImmune checkpoint inhibitorsMicrosatellite instabilityPrognosis

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Cancer Genomics

Background:

  • Immune checkpoint inhibitors (ICIs) show efficacy in treating cancers with high-grade microsatellite instability (MSI-H) or deficient mismatch repair protein (dMMR).
  • Recent approvals of PD-1 inhibitors (e.g., pembrolizumab) for advanced dMMR/MSI-H colorectal cancer and endometrial carcinoma highlight the clinical significance of these biomarkers.
  • Optimal diagnostic testing strategies for MSI-H/dMMR are needed to guide treatment decisions.

Purpose of the Study:

  • To re-evaluate the optimal testing methods for MSI-H/dMMR in routine diagnostics.
  • To propose a quality-assured, reliable, and cost-effective testing algorithm for MSI-H/dMMR detection.
  • To facilitate early consideration of predictive, prognostic, and predispositional implications of MSI-H/dMMR status for patient counseling and treatment planning.

Main Methods:

  • Evaluation of the strengths and weaknesses of widely available diagnostic methods: immunohistochemistry (IHC) and polymerase chain reaction (PCR).
  • Development of a proposed test algorithm for dMMR/MSI-H detection.
  • Alignment of testing recommendations with international guidelines (NICE, NCCN) for colorectal cancer (CRC) and endometrial carcinoma (EC).

Main Results:

  • A new testing algorithm enables quality-assured, reliable, and cost-effective dMMR/MSI-H detection.
  • Testing is feasible at the primary diagnosis stage for CRC and EC, aligning with international recommendations.
  • Clinicians can utilize MSI-H/dMMR test results for comprehensive patient counseling and treatment strategy formulation.

Conclusions:

  • The proposed algorithm supports routine, high-quality dMMR/MSI-H testing for optimizing ICI therapy selection.
  • Early detection of dMMR/MSI-H status in CRC and EC is critical for personalized cancer care.
  • Participation in interlaboratory comparisons and continuous data documentation are recommended for quality assurance.