Difference between revisions of "Microsatellite instability in colorectal cancer"

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Microsatellite instability in colorectal cancer (view source)

Revision as of 05:02, 9 August 2024

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trim out obsolete 'when to test'
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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 (written in 2015) from CAP, ASCO and others 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> Some use the Bethesda criteria (see below) and others have their own set of criteria.
====Bethesda criteria of 2004 for MSI testing====
MSI testing should be done if any of the following apply:<ref name=pmid14970275>{{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.
**MSI-H histology (any of the following): mucinous differentiation, signet ring differentiation, medullary growth pattern, [[TILs]], [[Crohn's like reaction]].
*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).
Notes:
*Formally known as ''Revised Bethesda Guidelines for Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome) and Microsatellite Instability''.
* †Includes: colorectum, endometrium, stomach, ovary, pancreas, ureter and renal pelvis, biliary tract and brain (usu. glioblastoma), [[sebaceous adenoma|sebaceous gland adenoma]]s and [[keratoacanthoma]] in [[Muir-Torre syndrome]] and small bowel carcinoma.<ref name=pmid14970275/>


===MSI classification===
===MSI classification===
Michael
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