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Evaluating morphological features for predicting microsatellite instability status in colorectal cancer
Ajay Malik1, Jasvinder Kaur Bhatia2, Kavita Sahai3
1Brig Med, Delhi Area, C/o 56 APO, India.
Medical Journal, Armed Forces India
|September 23, 2022
Summary
Microsatellite instability (MSI) occurs in 11.3% of colorectal cancers (CRC). Specific clinical and histological features can predict MSI, aiding in patient selection for testing.
Area of Science:
- Oncology
- Gastroenterology
- Cancer Research
Background:
- Colorectal cancer (CRC) is a prevalent global malignancy with significant heterogeneity.
- The microsatellite instability (MSI) pathway, linked to mismatch repair (MMR) gene defects, accounts for 10-15% of CRCs.
- Identifying MMR deficiency is crucial for CRC diagnosis, prognosis, and treatment prediction.
Purpose of the Study:
- To determine the prevalence of MSI in Indian CRC cases.
- To identify clinical and histological features associated with MSI.
- To evaluate the utility of histopathology in predicting MSI status.
Main Methods:
- Evaluation of 150 colon cancer cases in a tertiary hospital.
- Correlation of MSI status with various clinicopathological variables.
- Development of a predictive score based on clinicohistological parameters.
Main Results:
- MSI prevalence in the study cohort was 11.3%.
- Associated factors included tumor differentiation, stage, site, size, tumor-infiltrating lymphocytes, Crohn's-like lymphoid reaction, and dirty necrosis.
- A predictive 'P' score was developed to identify patients for MSI testing.
Conclusions:
- Clinical and histopathological features aid in stratifying CRC patients for MSI testing.
- This approach is economical, reproducible, and easily applicable for patient selection.
- Histopathological assessment offers a valuable tool for predicting MSI in colorectal cancer.
