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Efficient and reproducible identification of mismatch repair deficient colon cancer : Validation of the MMR index and comparison with other predictive models

Joost, Patrick LU ; Bendahl, Pär Ola LU ; Halvarsson, Britta LU ; Rambech, Eva LU and Nilbert, Mef LU (2013) In BMC Clinical Pathology 13(1). p.1-7
Abstract

Background: The identification of mismatch-repair (MMR) defective colon cancer is clinically relevant for diagnostic, prognostic and potentially also for treatment predictive purposes. Preselection of tumors for MMR analysis can be obtained with predictive models, which need to demonstrate ease of application and favorable reproducibility. Methods. We validated the MMR index for the identification of prognostically favorable MMR deficient colon cancers and compared performance to 5 other prediction models. In total, 474 colon cancers diagnosed ≥ age 50 were evaluated with correlation between clinicopathologic variables and immunohistochemical MMR protein expression. Results: Female sex, age ≥60 years, proximal tumor location, expanding... (More)

Background: The identification of mismatch-repair (MMR) defective colon cancer is clinically relevant for diagnostic, prognostic and potentially also for treatment predictive purposes. Preselection of tumors for MMR analysis can be obtained with predictive models, which need to demonstrate ease of application and favorable reproducibility. Methods. We validated the MMR index for the identification of prognostically favorable MMR deficient colon cancers and compared performance to 5 other prediction models. In total, 474 colon cancers diagnosed ≥ age 50 were evaluated with correlation between clinicopathologic variables and immunohistochemical MMR protein expression. Results: Female sex, age ≥60 years, proximal tumor location, expanding growth pattern, lack of dirty necrosis, mucinous differentiation and presence of tumor-infiltrating lymphocytes significantly correlated with MMR deficiency. Presence of at least 4 of the MMR index factors identified MMR deficient tumors with 93% sensitivity and 76% specificity and showed favorable reproducibility with a kappa value of 0.88. The MMR index also performed favorably when compared to 5 other predictive models. Conclusions: The MMR index is easy to apply and efficiently identifies MMR defective colon cancers with high sensitivity and specificity. The model shows stable performance with low inter-observer variability and favorable performance when compared to other MMR predictive models.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Colorectal cancer, Microsatellite instability, Mismatch repair, Pathology, Prediction model
in
BMC Clinical Pathology
volume
13
issue
1
pages
1 - 7
publisher
BioMed Central
external identifiers
  • scopus:84890308420
ISSN
1472-6890
DOI
10.1186/1472-6890-13-33
language
English
LU publication?
yes
id
f14e29f6-ddde-496d-90ef-a7d474c0bcb4
date added to LUP
2018-02-13 16:19:39
date last changed
2018-02-15 10:44:59
@article{f14e29f6-ddde-496d-90ef-a7d474c0bcb4,
  abstract     = {<p>Background: The identification of mismatch-repair (MMR) defective colon cancer is clinically relevant for diagnostic, prognostic and potentially also for treatment predictive purposes. Preselection of tumors for MMR analysis can be obtained with predictive models, which need to demonstrate ease of application and favorable reproducibility. Methods. We validated the MMR index for the identification of prognostically favorable MMR deficient colon cancers and compared performance to 5 other prediction models. In total, 474 colon cancers diagnosed ≥ age 50 were evaluated with correlation between clinicopathologic variables and immunohistochemical MMR protein expression. Results: Female sex, age ≥60 years, proximal tumor location, expanding growth pattern, lack of dirty necrosis, mucinous differentiation and presence of tumor-infiltrating lymphocytes significantly correlated with MMR deficiency. Presence of at least 4 of the MMR index factors identified MMR deficient tumors with 93% sensitivity and 76% specificity and showed favorable reproducibility with a kappa value of 0.88. The MMR index also performed favorably when compared to 5 other predictive models. Conclusions: The MMR index is easy to apply and efficiently identifies MMR defective colon cancers with high sensitivity and specificity. The model shows stable performance with low inter-observer variability and favorable performance when compared to other MMR predictive models.</p>},
  articleno    = {33},
  author       = {Joost, Patrick and Bendahl, Pär Ola and Halvarsson, Britta and Rambech, Eva and Nilbert, Mef},
  issn         = {1472-6890},
  keyword      = {Colorectal cancer,Microsatellite instability,Mismatch repair,Pathology,Prediction model},
  language     = {eng},
  month        = {12},
  number       = {1},
  pages        = {1--7},
  publisher    = {BioMed Central},
  series       = {BMC Clinical Pathology},
  title        = {Efficient and reproducible identification of mismatch repair deficient colon cancer : Validation of the MMR index and comparison with other predictive models},
  url          = {http://dx.doi.org/10.1186/1472-6890-13-33},
  volume       = {13},
  year         = {2013},
}