Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting
Introduction: In this era of prognosis based medicine, it is important to identify microsatellite unstable Colorectal Cancers (CRCs) as they offer good prospects to the patient and they respond poorly to 5-fluorouracil and platinum based chemotherapeutic regime. Aim: To find out the prevalence o...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/4c77fe4eb09e4ea0acd492baa7367574 |
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| Sumario: | Introduction: In this era of prognosis based medicine, it is important
to identify microsatellite unstable Colorectal Cancers (CRCs) as
they offer good prospects to the patient and they respond poorly
to 5-fluorouracil and platinum based chemotherapeutic regime.
Aim: To find out the prevalence of Microsatellite Instability-High
(MSI-H) in CRC, to identify clinicopathological features associated
with Microsatellite Instability (MSI) and assess the value of surgical
pathology in predicting MSI-H.
Materials and Methods: The present study was a case-control
study conducted in a tertiary care centre of Pune in Western
India from January 2013 to December 2020. Thirty-five CRCs
deficient in Mismatch Repair (MMR) proteins contrasted with 206
Microsatellite Stable (MSS) CRCs were studied and analysed for
a given set of clinical and histopathological parameters to find out
any correlation between the occurrence of microsatellite unstable
tumours and these variables were presented as percentages.
Results: In the present study, the prevalence rate of MSI-H was
found to be 14.5% and the statistical analysis was carried out using
the software Statistical Package for the Social Sciences (SPSS)
version 27.0. Univariate analysis revealed that right-sided/proximal
location of tumours, age at diagnosis less than 50 years, no
lymph node deposits (N0
disease), presence of Tumour Infiltrating
Lymphocytes (TILs), peri-tumoural reaction, mucinous component,
increased stromal plasma cells, histological heterogeneity, signet
ring/medullary component and Crohn-like reaction were all
statistically significant predictors of microsatellite instability (p-value
<0.05). Multivariate analysis of these significant parameters
revealed right-sided location of tumours, age at diagnosis less
than 50 years, N0
disease, and presence of TILs, increased stromal
plasma cells, histological heterogeneity and Crohn-like reaction to
be independent predictors.
Conclusion: Clinical parameters and histological evaluation is
handy in screening for the MSI-H colorectal carcinomas. This
would go a long way in selecting the patients who will require
confirmatory molecular testing and thus precluding the need of
Immunohistochemistry (IHC), which will be helpful in day-to-day
practice as it is uncomplicated, cost-effective and easy to replicate. |
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