Cargando…

Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization

Microsatellite instable gastric cancer (MSI-GC) is a specific molecular subtype of GC. We studied the phenotypes, genotypes, and clinicopathologic characteristics of MSI-GC in a white GC cohort and compared our findings with an extended literature review. The study cohort consisted of 482 patients....

Descripción completa

Detalles Bibliográficos
Autores principales: Mathiak, Micaela, Warneke, Viktoria S., Behrens, Hans-Michael, Haag, Jochen, Böger, Christine, Krüger, Sandra, Röcken, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147042/
https://www.ncbi.nlm.nih.gov/pubmed/26371427
http://dx.doi.org/10.1097/PAI.0000000000000264
_version_ 1782473601352466432
author Mathiak, Micaela
Warneke, Viktoria S.
Behrens, Hans-Michael
Haag, Jochen
Böger, Christine
Krüger, Sandra
Röcken, Christoph
author_facet Mathiak, Micaela
Warneke, Viktoria S.
Behrens, Hans-Michael
Haag, Jochen
Böger, Christine
Krüger, Sandra
Röcken, Christoph
author_sort Mathiak, Micaela
collection PubMed
description Microsatellite instable gastric cancer (MSI-GC) is a specific molecular subtype of GC. We studied the phenotypes, genotypes, and clinicopathologic characteristics of MSI-GC in a white GC cohort and compared our findings with an extended literature review. The study cohort consisted of 482 patients. Specimens were available from 452 cases and were used for immunostaining (MLH1, PMS2, MSH2, MSH6) and molecular biological analyses (BAT-25, BAT-26, NR-21, NR-24, NR-27; Epstein-Barr virus in situ hybridization). Thirty-four (7.5%) GCs were MSI. Loss of MLH1 and/or PMS2 was found in 30 (88%) MSI-GC, 3 (9%) showed loss of MSH2 and/or MSH6. One (3%) MSI-GC was identified only by molecular biological testing. A single case was heterogeneous and contained microsatellite-stable and instable tumor areas. Twenty-one (62%) MSI-GCs showed unusual histologic features. MSI-GC was not found in diffuse-type or Epstein-Barr virus-positive GC. MSI-GC was significantly more prevalent in elderly patients, distal stomach, and was associated with a significantly lower number of lymph node metastases and a significantly better overall and tumor-specific survival. MSI-GC constitutes a small but relevant subgroup of GC with distinct clinicopathologic characteristics. Our literature review illustrates the shortcomings of missing standardized testing algorithms with prevalences of MSI-GC ranging from 0% to 44.5%. Future studies should test the hypothesis that patients with MSI-GCs may not need adjuvant/perioperative chemotherapy. However, this will require a standardized, quality-controlled diagnostic algorithm of MSI for GC.
format Online
Article
Text
id pubmed-5147042
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-51470422016-12-22 Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization Mathiak, Micaela Warneke, Viktoria S. Behrens, Hans-Michael Haag, Jochen Böger, Christine Krüger, Sandra Röcken, Christoph Appl Immunohistochem Mol Morphol Research Articles Microsatellite instable gastric cancer (MSI-GC) is a specific molecular subtype of GC. We studied the phenotypes, genotypes, and clinicopathologic characteristics of MSI-GC in a white GC cohort and compared our findings with an extended literature review. The study cohort consisted of 482 patients. Specimens were available from 452 cases and were used for immunostaining (MLH1, PMS2, MSH2, MSH6) and molecular biological analyses (BAT-25, BAT-26, NR-21, NR-24, NR-27; Epstein-Barr virus in situ hybridization). Thirty-four (7.5%) GCs were MSI. Loss of MLH1 and/or PMS2 was found in 30 (88%) MSI-GC, 3 (9%) showed loss of MSH2 and/or MSH6. One (3%) MSI-GC was identified only by molecular biological testing. A single case was heterogeneous and contained microsatellite-stable and instable tumor areas. Twenty-one (62%) MSI-GCs showed unusual histologic features. MSI-GC was not found in diffuse-type or Epstein-Barr virus-positive GC. MSI-GC was significantly more prevalent in elderly patients, distal stomach, and was associated with a significantly lower number of lymph node metastases and a significantly better overall and tumor-specific survival. MSI-GC constitutes a small but relevant subgroup of GC with distinct clinicopathologic characteristics. Our literature review illustrates the shortcomings of missing standardized testing algorithms with prevalences of MSI-GC ranging from 0% to 44.5%. Future studies should test the hypothesis that patients with MSI-GCs may not need adjuvant/perioperative chemotherapy. However, this will require a standardized, quality-controlled diagnostic algorithm of MSI for GC. Lippincott Williams & Wilkins 2017-01 2016-12-05 /pmc/articles/PMC5147042/ /pubmed/26371427 http://dx.doi.org/10.1097/PAI.0000000000000264 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.
spellingShingle Research Articles
Mathiak, Micaela
Warneke, Viktoria S.
Behrens, Hans-Michael
Haag, Jochen
Böger, Christine
Krüger, Sandra
Röcken, Christoph
Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title_full Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title_fullStr Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title_full_unstemmed Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title_short Clinicopathologic Characteristics of Microsatellite Instable Gastric Carcinomas Revisited: Urgent Need for Standardization
title_sort clinicopathologic characteristics of microsatellite instable gastric carcinomas revisited: urgent need for standardization
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147042/
https://www.ncbi.nlm.nih.gov/pubmed/26371427
http://dx.doi.org/10.1097/PAI.0000000000000264
work_keys_str_mv AT mathiakmicaela clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT warnekeviktorias clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT behrenshansmichael clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT haagjochen clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT bogerchristine clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT krugersandra clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization
AT rockenchristoph clinicopathologiccharacteristicsofmicrosatelliteinstablegastriccarcinomasrevisitedurgentneedforstandardization