Impact of DNA mismatch repair proteins deficiency on number and ratio of lymph nodal metastases in colorectal adenocarcinoma.

Abstract

BACKGROUND:

Approximately 15 % of colorectal adenocarcinomas (CRCs) are characterized by an altered expression of DNA mismatch repair (MMR) proteins (i.e. MMR deficiency [MMRd]). Lymph node ratio (LNR) represents one of the most important prognostic markers in non-advanced CRCs. No significant data are available regarding LNR distribution depending on MMR status.

PURPOSE OF THE STUDY:

The aim of the present work was to compare pathological and clinical characteristics of MMRd tumors versus MMR proficient (MMRp) cases. Particular attention was paid to how these molecular sub-groups relate to the LNR.

MATERIALS AND METHODS:

A mono-Institutional series of 1037 consecutive surgically treated stage I-IV CRCs were retrospectively selected and data were obtained from pathological reports. Cases were characterized for MMR/MSI status by means of immunohistochemistry or for microsatellite instability (MSI) analysis.

RESULTS:

MMRd/MSI tumors (n = 194; 18.7 %) showed significant differences in comparison to MMRp lesions for sex (female prevalence 50.5 % vs 40.7 %; p = 0.013), age (74.2 vs 69.2; p < 0.001), location (right side; p < 0.001), diameter (larger than MMRp; p < 0.001), growth pattern (expansive pattern of growth; p < 0.001), peri- (p = 0.0002) and intra-neoplastic (p = 0.0018) inflammatory infiltrate, presence of perineural invasion (p < 0.001), stage (lower stage at presentation; p < 0.001), grade (higher prevalence of high-grade tumors; p < 0.001), and LNR (lower; p < 0.001).

CONCLUSIONS:

MMRd/MSI tumors are a distinct molecular CRC subtype characterized by a significantly lower LNR in comparison to MMRp lesions. These data further support the prognostic impact of MMRd/MSI status in early-stage CRCs.

• Authors: Federica Zannier, Valentina Angerilli, Gaya Spolverato, Stefano Brignola, Daniele Sandonà, Mariangela Balistreri, Marianna Sabbadin, Sara Lonardi, Francesca Bergamo, Claudia Mescoli, Marco Scarpa, Quoc Riccardo Bao, Angelo Paolo Dei Tos, Salvatore Pucciarelli, Emanuele L D Urso, Matteo Fassan
• Journal: Pathology, research and practice (Pathol Res Pract) Vol. 243 Pg. 154366 (Mar 2023) ISSN: 1618-0631 [Electronic] Germany
• PMID: 36774759 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Elsevier GmbH. All rights reserved.

Topics

• Humans
• Female
• DNA Mismatch Repair
• Retrospective Studies
• Microsatellite Instability
• Colorectal Neoplasms (pathology)
• Adenocarcinoma (pathology)