title: Clinical Significance and Prognostic Relevance of Microsatellite Instability in Sporadic Colorectal Cancer Patients.
abstract: Microsatellite instability (MSI) is a marker of the replication error phenotype. It is caused by impaired DNA mismatch repair processes (MMR), resulting in ineffectiveness of the mechanisms responsible for the DNA replication precision and postreplicative DNA repair. MSI underlies the pathogenesis of 10%-20% of colorectal cancer (CRC) cases. The data about the potential value of MMR status as a predictive factor for 5-fluorouracil (FU)-based chemotherapy remain unclear. According to National Comprehensive Cancer Network updated guidelines, MSI testing is recommended for all patients with stage II CRC because patients with MSI-H (high-frequency MSI) tumour may have a good prognosis and obtain no benefit from 5-FU-based adjuvant chemotherapy. The significance of the MSI status as a predictive factor for patients with metastatic disease was not confirmed. The association between the MSI status and the efficacy of the therapy based on anti-programmed death-1 receptor inhibitors requires further studies.
authors.affiliation: Department of Nutrition Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, 41-902 Bytom, Poland. ang.c@wp.pl.|Department of Clinical Oncology, Regional Specialised Hospital No. 4 in Bytom, 41-900 Bytom, Poland. ang.c@wp.pl.
authors.forename: Angelika
authors.initials: A
authors.lastname: Copija
authors.affiliation: Department of Propaedeutics Surgery, Chair of General, Colorectal and Polytrauma Surgery, School of Health Sciences in Katowice, Medical University of Silesia, 41-902 Bytom, Poland. dariusz_waniczek@interia.pl.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Waniczek
authors.affiliation: Department of Clinical Oncology, Regional Specialised Hospital No. 4 in Bytom, 41-900 Bytom, Poland. andrzejwitkos@poczta.fm.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Witkoś
authors.affiliation: Department of Internal Medicine, School of Public Health in Bytom, Medical University of Silesia, 41-902 Bytom, Poland. kk.walkiewicz@gmail.com.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Walkiewicz
authors.affiliation: Department of Nutrition Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, 41-902 Bytom, Poland. enowakowska-zajdel@sum.edu.pl.|Department of Clinical Oncology, Regional Specialised Hospital No. 4 in Bytom, 41-900 Bytom, Poland. enowakowska-zajdel@sum.edu.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowakowska-Zajdel
mesh_terms: D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D003106:Colon / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D053843:DNA Mismatch Repair; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D053842:Microsatellite Instability; D011379:Prognosis; D012007:Rectum / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil
keywords: colorectal cancer; microsatellite instability; mismatch repair