Effect of microsatellite instability on histopathological parameters and prognosis in colon cancers

Year 2023, Volume: 48 Issue: 1, 1 - 10, 31.03.2023

Tuğba Toyran , Kivilcim Erdogan , Emine Kılıç Bağır , Arbil Açıkalın , Merve Aksın , Semra Paydaş , Burak Mete , Seyda Erdogan

https://doi.org/10.17826/cumj.1217604

Cited By: 1

Abstract

Purpose: The aim of this study was to compare the clinicopathological features, while evaluating the frequency of MSI, and the survival rates in these patients in our patient group with MSI and microsatellite stabil (MSS) colorectal carcinomas (CRCs).
Materials and Methods: We retrospectively enrolled 146 patients who underwent colon resection between the years of 2014-2022. The expression of MSI status was evaluated by immunohistochemistry. The association of MSI status, presense of tumor-infiltrating lymphocytes (TILs), and tumor budding score with a patient’s survival was assessed by the Kaplan–Meier method and Cox regression analysis.
Results: There were 104 (71.2%) MSS cases and, 42 (28.8%) MSI cases. 15 (10.3%) MSI tumors were found to be MSI-low, and 27 (18.5%) to be MSI-high. MSI tumors were significantly associated with younger patients (<50), earlier stage (T1-T2), right localization, lower rate of lymph node metastasis, presence of mucinous component and TILs response. The Cox-regression model revealed TILs, tumor budding score, and MSI are variables that significantly affect survival. The presence of TILs exhibited a protective effect (Hazard ratio (HR)=0.446), which decreased the mortality risk by 2.24 times for the follow-up period, while the presence of high TBS increased the risk of mortality by HR=3.22.
Conclusion: This study revealed that patients with MSI CRCs may show unique clinicopathological features and should be evaluated using some guiding parameters that will improve survival.

Keywords

Colorectal carcinomas, microsatellite instability, tumor-infiltrating lymphocytes, tumor budding score, Kolon kanser, mikrosatellite instabilite, histopatolojik parametre

Kolon kanserlerinde mikrosatellite instabilitenin histopatolojik parametreler ve prognoz üzerine etkisi

Abstract

Amaç: Bu çalışmada, MSİ ile mikrosatellit stabil (MSS) kolorektal karsinomlu (KRK) hasta grubumuzda, klinikopatolojik özellikleri karşılaştırmayı, MSİ sıklığını ve bu hastalarda sağkalım oranlarını değerlendirmeyi amaçladık
Gereç ve Yöntem: Çalışmaya retrospektif olarak 2014-2022 yılları arasında kolon rezeksiyonu yapılan 146 hasta dahil edildi. MSI durumu, immünohistokimyal belirteçlerle değerlendirildi. MSI durumu, tümörü infiltre eden lenfositlerin (TIL'ler) varlığı ve tümör tomurcuklanma skorunun sağkalım ile olan ilişkisi, Kaplan-Meier yöntemi ve Cox regresyon analizi ile değerlendirildi.
Bulgular: Olgularımızın 104’ü (%71,2) MSS, 42’si (%28,8) MSİ’dir. MSI tümörlerin 15’i (%10,3) MSI-düşük, 27’si (%18,5) MSİ-yüksek olarak bulundu. MSİ tümörler, genç yaş (<50 yaş), erken evre (T1-T2), sağ kolon lokalizasyonu, düşük lenf nodu metastazı oranı, müsinöz komponent ve TİL varlığı ile istatistiksel olarak anlamlı şekilde ilişkiliydi. Cox-regresyon modeli, TIL'lerin, tümör tomurcuklanma skorunun ve MSİ'nin sağkalımı önemli ölçüde etkileyen değişkenler olduğunu ortaya çıkardı. TIL'lerin varlığı, takip süresince ölüm riskini 2,24 kat azaltan koruyucu bir etki (Tehlike oranı (HR)=0,446) sergilerken, yüksek tümör tomurcuklanma skorunun ölüm riskini (HR=3,22) artırdığı bulundu.
Sonuç: Çalışmamızda, MSİ KRK’li hastaların, kendilerine özgü klinikopatolojik özellikler gösterebileceği ve sağkalımda yol gösterici bazı parametrelerle birlikte değerlendirilmesi gerektiği vurgulanmaktadır.

Keywords

Kolon kanseri, mikrosatellite instabilite, histopatolojik parametre, prognoz

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