ORIGINAL ARTICLE
The concordance of DNA mismatch repair protein between endoscopic biopsies and surgical specimens and inter-observers variations in colorectal cancer patients: reflections from endoscope doctors
1
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China
2
Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Haidian District, Beijing, China
Submission date: 2019-06-11
Acceptance date: 2019-10-28
Publication date: 2020-05-20
Pol J Pathol 2020;71(1):13-19
KEYWORDS
TOPICS
ABSTRACT
Previous studies showed that the yield of immunohistochemistry (IHC) staining on endoscopic biopsies may be as good as on surgically removed tissues. However, we noted that some patients showed inconsistent DNA mismatch repair protein (MMRP) stains between biopsies and surgical specimens. In this study, we aimed to investigate factors which are related to the consistence of MMRP evaluation between two pathologists or between different tissues. Two pathologists were asked to diagnose 4 MMRP, both on endoscopic biopsies and surgical materials, in 51 colorectal cancer (CRC) patients, using a single blind method. The consistence of two specimens and inter-observers’ variances across different pathologists were compared respectively and the factors related to this variability were analyzed. Among the 816 paired MMRP, 804 (98.5%) pairs showed concordant IHC stains between biopsies and surgical materials, the agreement was almost perfect for MSH6 and PMS2 (k = 0.85, 0.85 separately); 804 (98.5%) pairs showed concordant IHC stains between two pathologists, the inter-observer agreement was almost perfect for MSH6 and PMS2 (k =0.85, 0.88 separately). Clinical and pathological characteristics analysis showed that biopsy number and TNM stage were related to the variations. Inter-observers variations should be taken into account during MMRP testing in colorectal cancers. Generous endoscopic biopsies could improve the accuracy of endoscopic biopsy for MMRP detection which can be used histological tool in the evaluation of CRC and a promising new prognostic factor for these patients.
REFERENCES (24)
1.
Gil-Raga M, Jantus-Lewintre E, Gallach S, et al. Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis. Clinical & Translational Oncology: Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 2018; 20: 1422-1429.
2.
Siegel RL, Miller KD, Fedewa SA, et al. Colorectal cancer statistics, 2017. CA Cancer J Clin 2017; 67: 177-193.
3.
Migliore L, Migheli F, Spisni R, et al. Genetics, cytogenetics, and epigenetics of colorectal cancer. J Biomed Biotechnol 2011; 2011: 79236.
4.
Laporte GA, Leguisamo NM, Kalil AN, et al. Clinical importance of DNA repair in sporadic colorectal cancer. Crit Rev Oncol Hematol 2018; 126: 168-185.
5.
Sinicrope FA, Foster NR, Thibodeau SN, et al. DNA mismatch repair status and colon cancer recurrence and survival in clinical trials of 5-fluorouracil-based adjuvant therapy. J Natl Cancer Inst 2011; 103: 863-875.
6.
Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 2017; 67: 93-99.
7.
Yoon YS, Yu CS, Kim TW, et al. Mismatch repair status in sporadic colorectal cancer: immunohistochemistry and microsatellite instability analyses. J Gastroenterol Hepatol 2011; 26: 1733-1739.
8.
Vilkin A, Leibovici-Weissman Y, Halpern M, et al. Immunohistochemistry staining for mismatch repair proteins: the endoscopic biopsy material provides useful and coherent results. Hum Pathol 2015; 46: 1705-1711.
9.
Vilkin A, Halpern M, Morgenstern S, et al. How reliable is immunohistochemical staining for DNA mismatch repair proteins performed after neoadjuvant chemoradiation? Hum Pathol 2014; 45: 2029-2036.
10.
O'Brien O, Ryan E, Creavin B, et al. Correlation of immunohistochemical mismatch repair protein status between colorectal carcinoma endoscopic biopsy and resection specimens. J Clin Pathol 2018; 71: 631-636.
11.
Kumarasinghe AP, de Boer B, Bateman AC, et al. DNA mismatch repair enzyme immunohistochemistry in colorectal cancer: a comparison of biopsy and resection material. Pathology 2010; 42: 414-420.
12.
Shia J, Stadler Z, Weiser MR, et al. Immunohistochemical staining for DNA mismatch repair proteins in intestinal tract carcinoma: how reliable are biopsy samples? Am J Surg Pathol 2011; 35: 447-454.
13.
Shia J, Tang LH, Vakiani E, et al. Immunohistochemistry as first-line screening for detecting colorectal cancer patients at risk for hereditary nonpolyposis colorectal cancer syndrome: a 2-antibody panel may be as predictive as a 4-antibody panel. Am J Surg Pathol 2009; 33: 1639-1645.
14.
Barrow E, Jagger E, Brierley J, et al. Semiquantitative assessment of immunohistochemistry for mismatch repair proteins in Lynch syndrome. Histopathology 2010; 56: 331-344.
15.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174.
16.
Cappellesso R, Lo Mele M, Munari G, et al. Molecular characterization of “sessile serrated” adenoma to carcinoma transition in six early colorectal cancers. Pathology, research and practice 2019; 215: 957-962.
17.
Soong TR, Nayor J, Stachler MD, et al. Clinicopathologic and genetic characteristics of interval colorectal carcinomas favor origin from missed or incompletely excised precursors. Modern Pathol 2019; 32: 666-674.
18.
Li GM. Mechanisms and functions of DNA mismatch repair. Cell Res 2008; 18: 85-98.
19.
Hewish M, Lord CJ, Martin SA, et al. Mismatch repair deficient colorectal cancer in the era of personalized treatment. Nat Rev Clin Oncol 2010; 7: 197-208.
20.
Sepulveda AR, Hamilton SR, Allegra CJ, et al. Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and the American Society of Clinical Oncology. J Clin Oncol 2017; 35: 1453-1486.
21.
Ryan E, Sheahan K, Creavin B, et al. The current value of determining the mismatch repair status of colorectal cancer: A rationale for routine testing. Crit Rev Oncol Hematol 2017; 116: 38-57.
22.
Overbeek LI, Ligtenberg MJ, Willems RW, et al. Interpretation of immunohistochemistry for mismatch repair proteins is only reliable in a specialized setting. Am J Surg Pathol 2008; 32: 1246-1251.
23.
Funkhouser WK Jr., Lubin IM, Monzon FA, et al. Relevance, pathogenesis, and testing algorithm for mismatch repair-defective colorectal carcinomas: a report of the association for molecular pathology. J Mol Diagn 2012; 14: 91-103.
24.
Adan Merino L, Mercedes AM, Jose BA, et al. Factors related to colorectal cancer in advanced adenomas and serrated polyps: a further step toward individualized surveillance. Eur J Gastroenterol Hepatol 2018; 30: 1337-1343.
Share
RELATED ARTICLE
| eISSN: | 2084-9869 |
| ISSN: | 1233-9687 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
