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Difference between revisions of "Colorectal tumours"
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*Abbreviated ''MSI cancers''. | *Abbreviated ''MSI cancers''. | ||
===General=== | ===General=== | ||
*Can be sporadic, i.e. non-syndromic.<ref name=pmid24199172>{{Cite journal | last1 = Heinimann | first1 = K. | title = Toward a Molecular Classification of Colorectal Cancer: The Role of Microsatellite Instability Status. | journal = Front Oncol | volume = 3 | issue = | pages = 272 | month = | year = 2013 | doi = 10.3389/fonc.2013.00272 | PMID = 24199172 }}</ref> | *Can be sporadic, i.e. non-syndromic.<ref name=pmid24199172>{{Cite journal | last1 = Heinimann | first1 = K. | title = Toward a Molecular Classification of Colorectal Cancer: The Role of Microsatellite Instability Status. | journal = Front Oncol | volume = 3 | issue = | pages = 272 | month = | year = 2013 | doi = 10.3389/fonc.2013.00272 | PMID = 24199172 }}</ref> | ||
*Strong association with [[Lynch syndrome]].<ref>{{Cite journal | last1 = Mensenkamp | first1 = AR. | last2 = Vogelaar | first2 = IP. | last3 = van Zelst-Stams | first3 = WA. | last4 = Goossens | first4 = M. | last5 = Ouchene | first5 = H. | last6 = Hendriks-Cornelissen | first6 = SJ. | last7 = Kwint | first7 = MP. | last8 = Hoogerbrugge | first8 = N. | last9 = Nagtegaal | first9 = ID. | title = Somatic mutations in MLH1 and MSH2 are a Frequent Cause of Mismatch-repair Deficiency in Lynch Syndrome-like Tumors. | journal = Gastroenterology | volume = | issue = | pages = | month = Dec | year = 2013 | doi = 10.1053/j.gastro.2013.12.002 | PMID = 24333619 }}</ref><ref name=pmid24199172/> | *Strong association with [[Lynch syndrome]].<ref>{{Cite journal | last1 = Mensenkamp | first1 = AR. | last2 = Vogelaar | first2 = IP. | last3 = van Zelst-Stams | first3 = WA. | last4 = Goossens | first4 = M. | last5 = Ouchene | first5 = H. | last6 = Hendriks-Cornelissen | first6 = SJ. | last7 = Kwint | first7 = MP. | last8 = Hoogerbrugge | first8 = N. | last9 = Nagtegaal | first9 = ID. | title = Somatic mutations in MLH1 and MSH2 are a Frequent Cause of Mismatch-repair Deficiency in Lynch Syndrome-like Tumors. | journal = Gastroenterology | volume = | issue = | pages = | month = Dec | year = 2013 | doi = 10.1053/j.gastro.2013.12.002 | PMID = 24333619 }}</ref><ref name=pmid24199172/> | ||
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*Prognosis: slightly better than other [[CRC]] without MSI. | *Prognosis: slightly better than other [[CRC]] without MSI. | ||
*Treatment implication: different response to chemotherapy. | *Treatment implication: different response to chemotherapy. | ||
====When to test==== | |||
*National Comprehensive Cancer Network (NCCN) in the USA recommends testing all individual with colorectal cancer that are under the age of 70 years.<ref>URL: [http://www.medscape.com/viewarticle/821981 http://www.medscape.com/viewarticle/821981]. Accessed on: 12 January 2016.</ref> | |||
*A draft document (2015) from CAP, ASCO suggests testing all colorectal cancer cases for MSI.<ref>URL: [http://www.amp.org/committees/clinical_practice/documents/20150327CRCMMDraftRecommendationsforOCP-UPDATEDfinaldraft_001.pdf http://www.amp.org/committees/clinical_practice/documents/20150327CRCMMDraftRecommendationsforOCP-UPDATEDfinaldraft_001.pdf]. Accessed on: 12 January 2016.</ref> | |||
*In Canada the guidelines vary by the province.<ref>URL: [http://www.ncbi.nlm.nih.gov/books/NBK321468/ http://www.ncbi.nlm.nih.gov/books/NBK321468/]. Accessed on: 12 January 2016.</ref> | |||
===Bethesda criteria of 2004 for MSI testing=== | |||
MSI testing should be done if any of the following apply:<ref>{{Cite journal | last1 = Umar | first1 = A. | last2 = Boland | first2 = CR. | last3 = Terdiman | first3 = JP. | last4 = Syngal | first4 = S. | last5 = de la Chapelle | first5 = A. | last6 = Rüschoff | first6 = J. | last7 = Fishel | first7 = R. | last8 = Lindor | first8 = NM. | last9 = Burgart | first9 = LJ. | title = Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. | journal = J Natl Cancer Inst | volume = 96 | issue = 4 | pages = 261-8 | month = Feb | year = 2004 | doi = | PMID = 14970275 }}</ref> | |||
*Colorectal cancer in patient <50 years old. | |||
*Colorectal cancer with MSI-H histology <60 years old. | |||
*Regardless of age - any of the following: | |||
**HNPCC-associated tumours. | |||
**Synchronous colorectal cancer. | |||
**Metachronous colorectal cancer. | |||
*Colorectal cancer in an individual with: | |||
**One or more first degree relatives with a HNPCC-related tumour diagnosed when <50 years old. | |||
**Two or more first- or second degree relatives with HNPCC-related tumours (diagnosed at any age). | |||
Note: | |||
*Formally known as ''Revised Bethesda Guidelines for Hereditary Nonpolyposis | |||
Colorectal Cancer (Lynch Syndrome) and Microsatellite Instability''. | |||
====MSI classification==== | ====MSI classification==== | ||