Prospective immunohistochemical analysis of primary colorectal cancers for loss of mismatch repair protein expression Journal Article


Authors: Lee-Kong, S. A.; Markowitz, A. J.; Glogowski, E.; Papadopoulos, C.; Stadler, Z.; Weiser, M. R.; Temple, L. K.; Guillem, J. G.
Article Title: Prospective immunohistochemical analysis of primary colorectal cancers for loss of mismatch repair protein expression
Abstract: Background: Evaluation of patients for Lynch syndrome includes assessment of age and family cancer history as well as testing for microsatellite instability and alterations in mismatch repair (MMR) genes. We examined the value of routine immunohistochemistry (IHC) for MMR proteins in patients with colorectal cancer (CRC) undergoing resection at a single institution. Patients and Methods: Beginning in July 2006, all patients aged < 50 years who were undergoing resection of primary CRC had their specimens routinely examined by IHC for MMR proteins. Patients aged 50-60 years were examined if histopathology suggestive of Lynch syndrome was reported, and patients of any age were examined if strong clinical suspicion was present. Family cancer history was analyzed and fulfillment of Amsterdam II criteria determined. Results: Over an 18-month period, 96 patients aged < 50 years underwent CRC resection. Out of these, 72 patients (75%) had immunohistochemical testing, with an overall MMR protein loss rate of 19%. In selected patients aged 50-60 years and > 60 years, loss rates were 26% and 65%, respectively. Of all patients with MMR protein loss, 10 (32%) had reported histopathology, and 3 (10%) had family histories suggesting Lynch syndrome. Conclusion: We demonstrate the feasibility of routine immunohistochemical testing for MMR proteins in patients with CRC. As only a minority of patients with MMR protein loss met Amsterdam II criteria or had suggestive histopathology reported, routine IHC may identify patients with Lynch syndrome who might otherwise be missed.
Keywords: immunohistochemistry; adult; controlled study; human tissue; protein expression; middle aged; cancer surgery; primary tumor; major clinical study; mutation; cancer localization; cancer patient; cancer staging; prospective study; prospective studies; gene expression profiling; protein depletion; neoplasm proteins; age factors; groups by age; colorectal neoplasms; microsatellite instability; dna mismatch repair; family history; lynch syndrome; mismatch repair protein; colorectal neoplasms, hereditary nonpolyposis; hereditary nonpolyposis colorectal cancer; amsterdam ii criteria; bethesda guidelines; mmr loss
Journal Title: Clinical Colorectal Cancer
Volume: 9
Issue: 4
ISSN: 1533-0028
Publisher: Elsevier Inc.  
Date Published: 2010-10-01
Start Page: 255
End Page: 259
Language: English
DOI: 10.3816/CCC.2010.n.038
PUBMED: 20920999
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: CCCLC" - "Source: Scopus"
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MSK Authors
  1. Arnold J Markowitz
    139 Markowitz
  2. Jose Guillem
    414 Guillem
  3. Zsofia Kinga Stadler
    391 Stadler
  4. Martin R Weiser
    538 Weiser
  5. Larissa Temple
    193 Temple