Prediction of mismatch repair deficient biliary tract cancer: Role of morphological features and host immune response detected by routine hematoxylin-eosin staining
Prediction of mismatch repair deficient biliary tract cancer: Role of morphological features and host immune response detected by routine hematoxylin-eosin staining
复制标题
错配修复缺陷型胆道癌的预测：常规苏木精-伊红染色检测的形态特征和宿主免疫反应的作用
DOI：
10.1002/jhbp.988
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Ohtsuka M
中科院分区：
文献类型：
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作者：
Suda R;Sakai N;Matsushita K;Ishige T;Kawasaki Y;Shiko Y;Furukawa K;Mishima T;Nakadai E;Ohtsuka M
背景/目的本研究的目的是确定日本胆管癌（BTC）伴DNA错配修复缺陷（dMMR）的频率和预测因素。方法对2001年至2017年期间接受BTC手术的662例患者的组织标本中的错配修复相关蛋白进行免疫染色和微卫星不稳定性分析，以识别dMMR-BTC。我们根据患者的人口统计学资料、病理学特征和宿主免疫反应（特征为间质肿瘤浸润淋巴细胞百分比（sTIL百分比）和三级淋巴结构（TLS））比较了dMMR‐BTC和熟练MMR（pMMR）‐BTC。dMMR-BTC的显著预测因素为原发灶为肝内胆管癌（OR 6.34，P = .004）、存在印戒细胞成分（OR 35.62，P < .001）、sTIL百分比≥40%（OR 3.43，P = .038）和存在TLS（OR 22.22，P < .001）。这四个变量中的任何一个或多个是阳性的敏感性，特异性和阴性似然比分别为93.3%，57.8%和0.12，分别为ConclusionEvaluation的组织病理学结果和宿主免疫反应的基础上，常规组织化学染色是有用的有效和廉价的诊断筛查dMMR‐BTC患者。
Background/PurposeThe objective of this study was to determine the frequency and predictors of biliary tract cancer (BTC) with deficient DNA mismatch repair (dMMR) in Japan.MethodsImmunostaining and microsatellite instability analysis were performed for mismatch repair‐related proteins in tissue specimens from 662 patients who underwent surgery for BTC between 2001 and 2017 to identify dMMR‐BTC. We compared dMMR‐BTC and proficient MMR (pMMR)‐BTC based on patient demographics, pathological features, and host immune responses characterized by the percentage of stromal tumor infiltrating lymphocytes (sTIL percentage) and tertiary lymphoid structures (TLS).ResultsThe incidence of dMMR‐BTC was 2.3%. Significant predictors of dMMR‐BTC were its primary lesion being intrahepatic cholangiocarcinoma (odds ratio [OR] 6.34,P= .004), presence of signet ring cell component (OR 35.62,P< .001), sTIL percentage ≥40% (OR 3.43,P= .038), and presence of TLS (OR 22.22,P< .001). The sensitivity, specificity, and negative likelihood ratio for any one or more of these four variables to be positive were 93.3%, 57.8%, and 0.12, respectively.ConclusionEvaluation of histopathological findings and host immune response based on conventional histochemical staining is useful for efficient and inexpensive diagnostic screening of dMMR‐BTC patients.