Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common hereditary colorectal cancer syndrome and accounts for about 5% of colorectal cancer. It is inherited as autosomal dominant type and is caused by germline mutations in mismatch repair genes such as MLH1, MSH2, MSH6, and PMS2. Patients with HNPCC are characterized by a high level of microsatellite instability. They commonly develop colorectal cancer at young age and increase risk of extra-colic malignancies, especially endometrial cancer. They also show better oncologic outcomes compared to sporadic colorectal cancer. Several tools are used in diagnosis of HNPCC, including history taking, microsatellite instability test, immunohistochemistry for mismatch repair protein, and gene test. Affected patients and their families should get genetic counseling and regular surveillance for cancers, which can improve their survival rate.
The purpose of this study was to evaluate MSI status in sporadic colorectal cancer and to correlate it with clinicopathologic variables.
Methods
Total 45 cases of surgically resected colorectal cancers retrospectively were reviewed about clinicopathologic findings and analyzed for micro satellite instability.
Results
The microsatellite instability (MSI) was found in 5 of 45 cases (11.1%) . A significant association was found between MSI+ tumors and location in the right colon (40%), and high histological grade (100.0%), and mucinous phenotype (33.3%). There was no significant difference for age, sex, growth pattern, lymph node metastases, vessel invasion, or Duke's stage.
Conclusion
These data indicate that MSI frequently occur in colorectal cancers of the right side and in tumors with poorly differentiated or mucinous histology.