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  • Low level microsatellite instability may be associated with reduced cancer specific survival in sporadic stage C colorectal carcinoma

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Colorectal cancer
Low level microsatellite instability may be associated with reduced cancer specific survival in sporadic stage C colorectal carcinoma
  1. C M Wright1,
  2. O F Dent2,
  3. R C Newland3,
  4. M Barker1,
  5. P H Chapuis2,
  6. E L Bokey2,
  7. J P Young1,
  8. B A Leggett1,
  9. J R Jass4,
  10. G A Macdonald5
  1. 1Conjoint Gastroenterology Laboratory, Royal Brisbane Hospital Research Foundation Clinical Research Centre, Brisbane, Australia
  2. 2Department of Colorectal Surgery, Concord Hospital and the University of Sydney, Australia
  3. 3Department of Anatomical Pathology, Concord Hospital and the University of Sydney, Australia
  4. 4Department of Pathology, The University of Queensland, Queensland Institute of Medical Research, Brisbane, Australia
  5. 5Department of Medicine, The University of Queensland, and the Division of Population Health and Clinical Sciences, Queensland Institute of Medical Research, Brisbane, Australia
  1. Correspondence to:
    Dr C Wright
    The Royal Prince Alfred Medical Centre, 419/100 Carillon Ave, Newtown, NSW 2042, Australia; carolinewrighthn.ozemail.com.au

Abstract

Background: Colorectal cancers (CRCs) may be categorised according to the degree of microsatellite instability (MSI) exhibited, as MSI-high (MSI-H), MSI-low (MSI-L), or microsatellite stable (MSS). MSI-H status confers a survival advantage to patients with sporadic CRC.

Aims: To determine if low levels of MSI are related to the clinicopathological features and prognosis of sporadic stage C CRC.

Patients: A total of 255 patients who underwent resection for sporadic stage C CRC were studied. No patient received chemotherapy. Minimum follow up was five years.

Methods: DNA extracted from archival malignant and non-malignant tissue was amplified by polymerase chain reaction using a panel of 11 microsatellites. MSI-H was defined as instability at ⩾40% of markers, MSS as no instability, and MSI-L as instability at >0% but <40% of markers. Patients with MSI-H CRC were excluded from analysis as they have previously been shown to have better survival.

Results: Thirty three MSI-L and 176 MSS CRCs were identified. There was no difference in biological characteristics or overall survival of MSI-L compared with MSS CRC but MSI-L was associated with poorer cancer specific survival (hazard ratio 2.0 (95% confidence interval 1.1–3.6)).

Conclusions: Sporadic MSI-L and MSS CRCs have comparable clinicopathological features. Further studies are required to assess the impact of MSI-L on prognosis.

  • CRC, colorectal cancer
  • MMR, mismatch repair
  • MSI, microsatellite instability
  • MSI-H, MSI-high
  • MSI-L, MSI-low
  • MSS, microsatellite stable
  • HNPCC, hereditary non-polyposis colorectal cancer
  • PCR, polymerase chain reaction
  • microsatellite instability
  • colorectal cancer
  • prognosis

https://doi.org/10.1136/gut.2003.034579

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    Footnotes

    • Conflict of interest: None declared.