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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oai:doaj.org-article:4c77fe4eb09e4ea0acd492baa73675742021-11-08T02:23:18ZComparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting10.7860/JCDR/2021/49545.153782249-782X0973-709Xhttps://doaj.org/article/4c77fe4eb09e4ea0acd492baa73675742021-09-01T00:00:00Zhttps://www.jcdr.net/articles/PDF/15378/49545_CE[Ra1]_F[SH]_PF1(AG_SHU)_PFA_PB(KM_AG)_PN(KM).pdfhttps://doaj.org/toc/2249-782Xhttps://doaj.org/toc/0973-709XIntroduction: 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.Divya ShellyKV Vinu BalraamReena BharadwajC BharaniJCDR Research and Publications Private Limitedarticledeoxyribonucleic acid mismatch repairimmunohistochemistrymicrosatellite instabilityMedicineRENJournal of Clinical and Diagnostic Research, Vol 15, Iss 9, Pp EC08-EC23 (2021) |
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| collection |
DOAJ |
| language |
EN |
| topic |
deoxyribonucleic acid mismatch repair immunohistochemistry microsatellite instability Medicine R |
| spellingShingle |
deoxyribonucleic acid mismatch repair immunohistochemistry microsatellite instability Medicine R Divya Shelly KV Vinu Balraam Reena Bharadwaj C Bharani Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| description |
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. |
| format |
article |
| author |
Divya Shelly KV Vinu Balraam Reena Bharadwaj C Bharani |
| author_facet |
Divya Shelly KV Vinu Balraam Reena Bharadwaj C Bharani |
| author_sort |
Divya Shelly |
| title |
Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| title_short |
Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| title_full |
Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| title_fullStr |
Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| title_full_unstemmed |
Comparison of Clinical and Histopathological Parameters amongst Microsatellite Unstable and Microsatellite Stable Cases of Colorectal Carcinomas in an Indian Setting |
| title_sort |
comparison of clinical and histopathological parameters amongst microsatellite unstable and microsatellite stable cases of colorectal carcinomas in an indian setting |
| publisher |
JCDR Research and Publications Private Limited |
| publishDate |
2021 |
| url |
https://doaj.org/article/4c77fe4eb09e4ea0acd492baa7367574 |
| work_keys_str_mv |
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| _version_ |
1718443279268184064 |