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Prediction of mismatch repair deficient biliary tract cancer: Role of morphological features and host immune response detected by routine hematoxylin‐eosin staining
Author(s) -
Suda Ryuichiro,
Sakai Nozomu,
Matsushita Kazuyuki,
Ishige Takayuki,
Kawasaki Yohei,
Shiko Yuki,
Furukawa Katsunori,
Mishima Takashi,
Nakadai Eri,
Ohtsuka Masayuki
Publication year - 2021
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.988
Subject(s) - dna mismatch repair , microsatellite instability , h&e stain , immunostaining , pathology , tumor infiltrating lymphocytes , medicine , immune system , immunohistochemistry , cancer , biology , immunology , colorectal cancer , immunotherapy , microsatellite , gene , allele , biochemistry
Background/Purpose The objective of this study was to determine the frequency and predictors of biliary tract cancer (BTC) with deficient DNA mismatch repair (dMMR) in Japan. Methods Immunostaining and microsatellite instability analysis were performed for mismatch repair‐related proteins in tissue specimens from 662 patients who underwent surgery for BTC between 2001 and 2017 to identify dMMR‐BTC. We compared dMMR‐BTC and proficient MMR (pMMR)‐BTC based on patient demographics, pathological features, and host immune responses characterized by the percentage of stromal tumor infiltrating lymphocytes (sTIL percentage) and tertiary lymphoid structures (TLS). Results The incidence of dMMR‐BTC was 2.3%. Significant predictors of dMMR‐BTC were its primary lesion being intrahepatic cholangiocarcinoma (odds ratio [OR] 6.34, P = .004), presence of signet ring cell component (OR 35.62, P < .001), sTIL percentage ≥40% (OR 3.43, P = .038), and presence of TLS (OR 22.22, P < .001). The sensitivity, specificity, and negative likelihood ratio for any one or more of these four variables to be positive were 93.3%, 57.8%, and 0.12, respectively. Conclusion Evaluation of histopathological findings and host immune response based on conventional histochemical staining is useful for efficient and inexpensive diagnostic screening of dMMR‐BTC patients.