Assessment of concordance between immunohistochemistry and MSI analysis and their association with clinicopathological features in Malaysian colorectal cancer patients
Introduction: Colorectal cancer (CRC) is the second most common tumour in Malaysia. Universal screening for the identification of microsatellite instability/mismatch repair (MSI/MMR) status in CRC patients is recommended by several guidelines. The detection of MSI/MMR status in CRC patients is not...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English English English |
| Published: |
KAHS
2021
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/90518/7/View%20of%20ASSESSMENT%20OF%20CONCORDANCE%20BETWEEN%20IMMUNOHISTOCHEMISTRY%20AND%20MSI%20ANALYSIS%20AND%20THEIR%20ASSOCIATION%20WITH%20CLINICOPATHOLOGICAL%20FEATURES%20IN%20MALAYSIAN%20COLORECTAL%20CANCER%20PATIENTS.html http://irep.iium.edu.my/90518/1/abstract%20KRD%202020.pdf http://irep.iium.edu.my/90518/8/90518_Assessment%20of%20concordance%20between%20immunohistochemistry.pdf http://irep.iium.edu.my/90518/ https://journals.iium.edu.my/ijahs/index.php/IJAHS/article/view/565/531 |
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| Summary: | Introduction: Colorectal cancer (CRC) is the second most common tumour in Malaysia. Universal screening for the
identification of microsatellite instability/mismatch repair (MSI/MMR) status in CRC patients is recommended by
several guidelines. The detection of MSI/MMR status in CRC patients is not only essential to identify Lynch
Syndrome (LS), but it also has predictive and prognostic values. The study aimed to investigate the MMR and MSI
status among CRC patients as well as to assess the concordance between immunohistochemistry (IHC) and MSI
analysis.
Method: Formalin-fixed paraffin-embedded (FFPE) tissue blocks of 123 CRC patients were retrieved for the years
2017-2018. For IHC and MSI analysis, EnVisionTM FLEX, Mini Kit, High PH, and MSI Analysis System 1.2 (Promega)
were utilized, respectively. MSI analysis was performed on selected deficient mismatch repair (dMMR) and
proficient mismatch repair (pMMR) cases.
Results: IHC detected 11.4% (14 out of 123) patients as dMMR and 88.6% (109 out of 123) as pMMR. MSI analysis
identified 26% (13 out of 50) patients as MSI-H, 6% (3 out of 50) patients as MSI-L, and 64% (32 out of 50) patients as
MSS. Both the IHC and MSI analysis showed perfect agreement (0.896, Kappa value) for the recognition of dMMR
or MSI-H CRC patients while demonstrating only 4% (2 out of 50) discordant results. Almost all dMMR patients
detected by IHC were recognized by MSI analysis as MSI-H except one.
Conclusion: The significant prevalence of dMMR in the current cohort supports the recommendation that the
assessment of MSI/MMR status should be addressed in CRC patients. The selection of the choice method may be
based on the availability of expertise and equipment. Since IHC is an affordable, reproducible, and readily available
in most histopathological laboratories, it can be used as a primary screening test to detect MSI/MMR status in CRC
patients. |
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