Mismatch Repair Deficiency in Colorectal Adenocarcinoma: Clinical,
Pathological and Prognostic Features, a Single Center’s Experience of
1002 Cases
Abstract
Background and Study Aims: Microsatellite instability pathway caused by
loss of DNA “Mismatch Repair genes” (MMR) is responsible of Lynch
Syndrome-related tumors and 10-15% of sporadical colorectal cancers.
Although MSI-test is regarded as the golden standard for detection of
“Lynch Syndrome-related tumors”, there are increasing evidence on
similar analytic sensitivity of immunohistochemical evaluations.
Patinets and Metods: We retrospectively evaluated 1002 colorectal tumors
for loss of DNA MMR protein (MLH1, PMS2, MSH2, MSH6)
immunohistochemically. The results were correlated with
clinicopathological features and high level-microsatellite instability
(MSI-H) related histological parameters. Results: MMR protein expression
loss was observed in 9.8% of the cases. MLH1-PMS2 loss (53.2%) was the
most common loss followed by MSH2-MSH6 (31.6%), isolated PMS2 loss
(12%), and isolated MSH6 loss (2%). MMR deficiency was more frequent
under 50 years-old (p<0.0001), in right colon tumors
(p<0.0001), poorly differentiated tumors (p<0.0001),
tumors with tumor infiltrating lymphocytes (p<0.0001),
mucinous component (p=0.001), and medullary component
(p<0.0001). Also MMR deficiency was less frequent in tumor
with tumor budding (p<0.0001) and dirty necrosis
(p<0.0001). The 5 years-survival rate was 55.7%. No
significant correlation was found with MMR deficiency and survival.
Conclusions: MMR deficiency was observed in 9.8% of the cases with
distinct clinicopathological features. The results were consistent with
previous studies. Unlike the literature, we did not find any
statistically significant difference between MMR deficiency and
prognosis.