Clinicopathologic features in colorectal cancer patients with microsatellite instability.
The microsatellite instability (MSI) mutational pathway is critical to carcinogenesis in a small but significant proportion of colorectal cancers. While MSI is identified in most cancers in individuals with hereditary non-polyposis colorectal cancer, the majority of MSI tumors are found in individuals with sporadic disease. Colorectal cancers arising as a result of MSI have distinct clinicopathologic features distinguishing them from those with microsatellite stability. MSI colorectal cancers affect a larger percentage of women, are usually localized proximal to the splenic flexure, and have a higher incidence of synchronous and metachronous tumors. They are associated with a mucinous histology, tumor-infiltrating lymphocytes, a Crohn's-like inflammatory response, and a higher grade but lower stage. Overall survival is better in individuals with MSI. The benefit of chemotherapy in MSI colorectal cancers, with and without lymph node metastases, remains unclear.
Raut
Chandrajit P
CP
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Pawlik
Timothy M
TM
Rodriguez-Bigas
Miguel A
MA
D020137:Base Pair Mismatch / Q000235:genetics; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D019175:DNA Methylation; D004260:DNA Repair / Q000235:genetics; D004358:Drug Therapy; D042822:Genomic Instability; D006801:Humans; D018895:Microsatellite Repeats / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D011379:Prognosis