当前位置： SCI文献检索 > GASTROENTEROLOGY期刊下所有文献 > Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study.

Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study.

Abstract：

BACKGROUND & AIMS:The revised Bethesda guidelines for Lynch syndrome recommend microsatellite instability (MSI) testing all colorectal cancers in patients diagnosed before age 50 years and colorectal cancers diagnosed in patients between ages 50 and 59 years with particular pathology features. Our aim was to identify pathology and other features that independently predict high MSI (MSI-H). METHODS:Archival tissue from 1098 population-based colorectal cancers diagnosed before age 60 years was tested for MSI. Pathology features, site, and age at diagnosis were obtained. Multiple logistic regression was performed to determine the predictive value of each feature, as measured by an odds ratio (OR), from which a scoring system (MsPath) was developed to estimate the probability a colorectal cancer is MSI-H. RESULTS:Fifteen percent of tumors (162) were MSI-H. Independent predictors were tumor-infiltrating lymphocytes (OR, 9.1; 95% confidence interval [CI], 5.9-14.1), proximal subsite (OR, 4.7; 95% CI, 3.1-7.3), mucinous histology (OR, 2.8; 95% CI, 1.7-4.8), poor differentiation (OR, 1.9; 95% CI, 1.2-3.1), Crohn's-like reaction (OR, 1.9; 95% CI, 1.2-2.9), and diagnosis before age 50 years (OR, 1.9; 95% CI, 1.3-2.9). MsPath score >or=1.0 had a sensitivity of 93% and a specificity of 55% for MSI-H. CONCLUSIONS:The probability an individual colorectal cancer is MSI-H is predicted well by the MsPath score. There is little value in testing for DNA mismatch repair loss in tumors, or for germline mismatch repair mutations, for colorectal cancers diagnosed in patients before age 60 years with an MSPath score <1 (approximately 50%). Pathology can identify almost all MSI-H colorectal cancers diagnosed before age 60 years.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Jenkins MA,Hayashi S,O'Shea AM,Burgart LJ,Smyrk TC,Shimizu D,Waring PM,Ruszkiewicz AR,Pollett AF,Redston M,Barker MA,Baron JA,Casey GR,Dowty JG,Giles GG,Limburg P,Newcomb P,Young JP,Walsh MD,Thibodeau SN,Lindor NM

doi

10.1053/j.gastro.2007.04.044

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

48-56

issue

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(07)00830-X

journal_volume

133

pub_type

杂志文章

在线工具

Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study.