Microsatellite instability screening should be done for right-sided colon cancer patients less than 60 years of age
Microsatellite instability screening should be done for right-sided colon cancer patients less than 60 years of age
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DOI：
10.1007/s00384-009-0815-y
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发表时间：
2010-01-01
影响因子：
2.8
通讯作者：
Chang, Shin-Ching
中科院分区：
文献类型：
--
作者：
Chou, Chia-Lin;Lin, Jen-Kou;Chang, Shin-Ching
微卫星分析是一种用于鉴别Lynch综合征的筛查工具。我们评估了160例60岁结直肠癌患者中高频微卫星不稳定性（MSI-H）的发生率，以确定这些个体是否应该进行常规微卫星不稳定性检测。从2004年1月至2006年12月，我们检测了160例60岁以下结直肠癌患者的微卫星不稳定性。MSI-H的发生率为11.3%（18/160），且多位于右侧（56%，P < 0.001），病理分期较低（72%，P = 0.011）。在18个MSI-H肿瘤中，6个显示出特征性MSI组织学。此外，在18个MSI-H肿瘤中，BAT-26的不稳定性为100%，BAT-25为94%，D17 S250为72%，D2 S123为68%，D5 S346为68%。在MSI-H肿瘤患者中，55.6%的患者年龄超过50岁，约70%的MSI-H肿瘤未显示特征性MSI组织学。重要的是，在这项研究中，高达40%的MSI-H患者会被忽视使用修订后的贝塞斯达指南。修订后的Bethesda指南，扩大到包括右侧结肠癌患者，可以确定94%的MSI-H肿瘤在这项研究中。MSI-H结直肠癌主要位于右侧，并有早期病理阶段。本研究结果提示，微卫星不稳定性检测应适用于所有60岁以下的右半结肠癌患者。
Microsatellite analysis is a screening tool used for the identification of Lynch syndrome. We evaluated the occurrence of high-frequency microsatellite instability (MSI-H) in 160 patients with colorectal cancer a parts per thousand currency sign60 years old to determine if these individuals should be routinely tested for microsatellite instability.From January 2004 and December 2006, we tested specimens of colorectal cancer from 160 patients under 60 years of age for microsatellite instability. The relationships between clinicopathological parameters and MSI-H status were analyzed.MSI-H occurred in 11.3% (18/160) of the tumors assayed, and colorectal tumors with MSI-H status were located predominantly to the right side (56%, P < 0.001) and had a lower pathological stage (72%, P = 0.011). Of the 18 MSI-H tumors, six displayed characteristic MSI histology. Furthermore, of the 18 MSI-H tumors, instability in BAT-26 was 100%, BAT-25 was 94%, D17S250 was 72%, D2S123 was 68%, and D5S346 was 68%. Of the patients with MSI-H tumors, 55.6% were more than 50 years of age, and about 70% of MSI-H tumors did not display characteristic MSI histology. Importantly, up to 40% of the MSI-H patients in this study would have been overlooked using the revised Bethesda guidelines. The revised Bethesda guidelines, broadened to include patients with right-sided colon cancer, could have identified 94% of the MSI-H tumors in this study.Colorectal cancers with MSI-H were predominantly located on the right side and had an early pathological stage. The results of this study suggest that microsatellite instability test should be used for all patients under 60 years of age with right-sided colon cancer.