Microsatellite instability and its impact on nutritional and inflammatory profiles in colorectal cancer

Microsatellite instability (MSI) is a critical molecular feature in colorectal cancer (CRC) that not only determines response to immunotherapy but also influences systemic nutritional and inflammatory status. MSI-high (MSI-H) CRC is characterized by heightened systemic inflammation, altered cytokine profiles, and unique gut microbiota compositions. Concurrently, MSI-H patients often exhibit poorer nutritional status, as reflected by lower body mass index, decreased serum albumin, and metabolic dysregulation. These immunonutritional alterations influence patient outcomes by affecting prognosis, response to therapy, and overall survival. This editorial summarizes current evidence linking MSI status with inflammatory and nutritional markers, highlighting the clinical implications of integrating nutritional assessment and inflammatory modulation into the maagement of CRC patients.