論文

国際誌
2022年9月20日

Clinicopathological and molecular characterization of deficient mismatch repair colorectal cancer.

Human pathology
  • Atsushi Yamada
  • ,
  • Yoshihiro Yamamoto
  • ,
  • Sachiko Minamiguchi
  • ,
  • Mayumi Kamada
  • ,
  • Tomohiko Sunami
  • ,
  • Shinya Ohashi
  • ,
  • Hiroshi Seno
  • ,
  • Kenji Kawada
  • ,
  • Manabu Muto

130
開始ページ
1
終了ページ
9
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.humpath.2022.09.005

Tumors demonstrating deficient mismatch repair (dMMR) account for 12%-15% of colorectal cancers (CRCs), but their characteristics have not been fully elucidated. The aim of this study was to characterize dMMR CRCs in terms of clinicopathological findings and molecular alterations. Immunostaining for mismatch repair (MMR) proteins was performed to determine MMR status, and then MLH1 promoter methylation and genetic variants of 25 genes involved in colorectal carcinogenesis were analyzed by next-generation sequencing in dMMR tumors. Coexistence of precancerous lesions was histologically evaluated to characterize the type of precursors. Immunohistochemistry revealed 34 dMMR tumors in 492 CRCs. Among dMMR CRCs, there were 25 MLH1 methylation-positive, 16 BRAF V600E variant-positive, and 7 KRAS variant-positive tumors. Positive MLH1 methylation was associated with BRAF V600E, older age, and right-side tumor location. MLH1 methylated BRAF/KRAS wild-type tumors were distinct in that all 5 tumors possessed variants in ligand-independent WNT signaling genes including APC, AXIN2, and CTNNB1. Among 10 dMMR CRCs that presented with precancerous lesions, 4 BRAF variant-positive, 1 KRAS variant-positive, and 2 BRAF/KRAS wild-type MLH1 methylated tumors coexisted with serrated lesions, while 1 MLH1 methylated BRAF/KRAS wild-type tumor and 2 MLH1 unmethylated tumors accompanied conventional adenomas. The current study characterized distinct subgroups of dMMR CRCs based on molecular alterations including MLH1 methylation and variants in BRAF, KRAS, and ligand-independent WNT signaling genes. The existence of distinct precursor lesions including serrated lesion and conventional adenoma further illustrates the involvement of heterogenous carcinogenetic pathways in the development of dMMR CRCs.

リンク情報
DOI
https://doi.org/10.1016/j.humpath.2022.09.005
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/36150551
ID情報
  • DOI : 10.1016/j.humpath.2022.09.005
  • PubMed ID : 36150551

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