Document Type : Original Research
Authors
1 Department of Pathology, Medical School of Shiraz University, Shiraz, Iran
2 Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3 Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background & Objective: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. n this study, we aimed to evaluate the clinicopathological and immunohistochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing.
Methods: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable.
Results: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration.
Conclusion: It was concluded that immunohistochemistry is a specific method for the diagnosis of MSI colorectal cancers, but false negative rate is high, and sensitivity is low. Therefore, we recommend performing molecular studies by DNA sequencing in colon cancer with clinical suspicion to MSI and negative immunohistochemistry
Keywords
Main Subjects
- Dolatkhah R, Somi MH, Bonyadi MJ, Asvadi Kermani I, Farassati F, Dastgiri S. Colorectal cancer in iran: molecular epidemiology and screening strategies. J Cancer Epidemiol. 2015;2015:643020. [DOI:10.1155/2015/643020]
- Kolahdoozan S, Sadjadi A, Radmard AR, Khademi H. Five Common Cancers in Iran. Arch Iran Med. 2010;13(2):143-6.
- Faghani M, Fakhrieh Asl S, Mansour-Ghanaei F, Aminian K, Tarang A, Seighalani R, et al. The Correlation between Microsatellite Instability and the Features of Sporadic Colorectal Cancer in the North Part of Iran. Gastroenterol Res Pract. 2012;2012:756263. [DOI:10.1155/2012/756263]
- Ashktorab H, Brim H, Al-Riyami M, Date A, Al-Mawaly K, Kashoub M, et al. Sporadic colon cancer: mismatch repair immunohistochemistry and microsatellite instability in Omani subjects. Dig Dis Sci. 2008;53(10):2723-31. [DOI:10.1007/s10620-007-0189-3]
- Amira AT, Mouna T, Ahlem B, Raoudha A, Majid BH, Amel H, et al. Immunohistochemical expression pattern of MMR protein can specifically identify patients with colorectal cancer microsatellite instability. Tumour Biol. 2014;35(7):6283-91. [DOI:10.1007/s13277-014-1831-2]
- Bavi PP, Abubaker JA, Jehan ZD, Al-Jomah NA, Siraj AK, Al-Harbi SR, et al. Colorectal carcinomas from Middle East - Molecular and tissue microarray analysis of genomic instability pathways. Saudi Medical Journal. 2008;29(1):75-80.
- Gomez-Alvarez MA, Lino-Silva LS, Salcedo-Hernandez RA, Padilla-Rosciano A, Ruiz-Garcia EB, Lopez-Basave HN, et al. Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability. Gastroenterol Rev. 2017;12(3):208-14. [DOI:10.5114/pg.2016.64740]
- Shahsiah R, Salarvand S, Miri R, Ghalehtaki R, Rakhshani N. The Prevalence and Associated Factors of Microsatellite Instability in Ovarian Epithelial Cancers Detected by Molecular Genetic Studies in a Sample of Iranian Women. Int J Cancer Manag. 2017;10(12). [DOI:10.5812/ijcm.11599]
- Arakawa K, Hata K, Kawai K, Tanaka T, Nishikawa T, Sasaki K, et al. Predictors for High Microsatellite Instability in Patients with Colorectal Cancer Fulfilling the Revised Bethesda Guidelines. Anticancer Res. 2018;38(8):4871-6. [DOI:10.21873/anticanres.12800]
- Kawakami H, Zaanan A, Sinicrope FA. Microsatellite instability testing and its role in the management of colorectal cancer. Curr Treat Options Oncol. 2015;16(7):30. [DOI:10.1007/s11864-015-0348-2]
- Karahan B, Argon A, Yildirim M, Vardar E. Relationship between MLH-1, MSH-2, PMS-2,MSH-6 expression and clinicopathological features in colorectal cancer. Int J Clin Exp Pathol. 2015;8(4):4044-53.
- Lanza G, Gafa R, Maestri I, Santini A, Matteuzzi M, Cavazzini L. Immunohistochemical pattern of MLH1/MSH2 expression is related to clinical and pathological features in colorectal adenocarcinomas with microsatellite instability. Mod Pathol. 2002;15(7):741-9. [DOI:10.1097/01.MP.0000018979.68686.B2]
- Ismael NE, El Sheikh SA, Talaat SM, Salem EM. Mismatch Repair Proteins and Microsatellite Instability in Colorectal Carcinoma (MLH1, MSH2, MSH6 and PMS2): Histopathological and Immunohistochemical Study. Open Access Maced J Med Sci. 2017;5(1):9-13. [DOI:10.3889/oamjms.2017.003]
- Katafygiotis P, Sakellariou S, Chatziandreou I, Giannopoulou I, Thymara I, Saetta AA, et al. Microsatellite Instability in Greek Colorectal Carcinoma Patients: Clinicopathological and Molecular Correlations. Anticancer Res. 2019;39(11):6379-87. [DOI:10.21873/anticanres.13851]
- Hameed F, Goldberg PA, Hall P, Algar U, van Wijk R, Ramesar R. Immunohistochemistry detects mismatch repair gene defects in colorectal cancer. Colorectal Dis. 2006; 8: 411-7. [DOI:10.1111/j.1463-1318.2006.00956.x]
)