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Clinical implications of microsatellite instability in T1 colorectal cancer

Authors
 Jeonghyun Kang  ;  Hak Woo Lee  ;  Im-kyung Kim  ;  Nam Kyu Kim  ;  Seung-Kook Sohn  ;  Kang Young Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.56(1) : 175-181, 2015 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/genetics* ; Colorectal Neoplasms/pathology* ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis/pathology ; Male ; Microsatellite Instability* ; Microsatellite Repeats/genetics ; Middle Aged ; Neoplasm Staging ; Risk Factors ; Survival Analysis
Keywords
Microsatellite instability ; T1 ; early colorectal cancer ; lymph node metastasis ; prognosis
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.
Files in This Item:
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DOI
10.3349/ymj.2015.56.1.175.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Im Kyung(김임경) ORCID logo https://orcid.org/0000-0001-8505-5307
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139280
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