Clinical Implications of Microsatellite Instability in T1 Colorectal Cancer.
10.3349/ymj.2015.56.1.175
- Author:
Jeonghyun KANG
1
;
Hak Woo LEE
;
Im Kyung KIM
;
Nam Kyu KIM
;
Seung Kook SOHN
;
Kang Young LEE
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. kylee117@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Microsatellite instability;
lymph node metastasis;
early colorectal cancer;
T1;
prognosis
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Colorectal Neoplasms/*genetics/*pathology;
Female;
Humans;
Lymph Nodes/pathology;
Lymphatic Metastasis/pathology;
Male;
*Microsatellite Instability;
Microsatellite Repeats/genetics;
Middle Aged;
Neoplasm Staging;
Risk Factors;
Survival Analysis
- From:Yonsei Medical Journal
2015;56(1):175-181
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The estimation of regional lymph node metastasis (LNM) risk in T1 colorectal cancer is based on histologic examination and imaging of the primary tumor. High-frequency microsatellite instability (MSI-H) is likely to decrease the possibility of metastasis to either regional lymph nodes or distant organs in colorectal cancers. This study evaluated the clinical implications of MSI in T1 colorectal cancer with emphasis on the usefulness of MSI as a predictive factor for regional LNM. MATERIALS AND METHODS: A total of 133 patients who underwent radical resection for T1 colorectal cancer were included. Genomic DNA was extracted from normal and tumor tissues and amplified by polymerase chain reaction (PCR). Five microsatellite markers, BAT-25, BAT-26, D2S123, D5S346, and D17S250, were used. MSI and clinicopathological parameters were evaluated as potential predictors of LNM using univariate and multivariate analyses. RESULTS: Among 133 T1 colorectal cancer patients, MSI-H, low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS) colorectal cancers accounted for 7.5%, 6%, and 86.5%, respectively. MSI-H tumors showed a female predominance, a proximal location and more retrieved lymph nodes. Twenty-two patients (16.5%) had regional LNM. Lymphovascular invasion and depth of invasion were significantly associated with LNM. There was no LNM in 10 MSI-H patients; however, MSI status was not significantly correlated with LNM. Disease-free survival did not differ between patients with MSI-H and those with MSI-L/MSS. CONCLUSION: MSI status could serve as a negative predictive factor in estimating LNM in T1 colorectal cancer, given that LNM was not detected in MSI-H patients. However, validation of our result in a different cohort is necessary.
