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A simple immunohistochemical algorithm predicts the risk of distant metastases in right‐sided colon cancer
Author(s) -
Neumann Jens,
Horst David,
Kriegl Lydia,
Maatz Susanne,
Engel Jutta,
Jung Andreas,
Kirchner Thomas
Publication year - 2012
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2011.04126.x
Subject(s) - mlh1 , microsatellite instability , immunohistochemistry , colorectal cancer , medicine , cancer , metastasis , pathology , oncology , biology , dna mismatch repair , allele , biochemistry , microsatellite , gene
Neumann J, Horst D, Kriegl L, Maatz S, Engel J, Jung A & Kirchner T
(2012) Histopathology 60, 416–426
A simple immunohistochemical algorithm predicts the risk of distant metastases in right‐sided colon cancer Aims: A test predicting distant metastases would be valuable for prognostication in colon cancer (CC). In previous studies, CC with microsatellite instability (MSI) showed a reduced risk of distant metastases. High expression of CD133 and β‐catenin, both related to cancer stem cell phenotypes, might be predictive markers for metastasis. The aim of this study was to develop a simple and robust test for risk assessment of distant metastases in CC. Methods and results: In a case–control study, 57 cases of right‐sided CC specimens with synchronous distant metastases were matched with 57 CC without distant metastases. Immunohistochemistry for MLH1, CD133 and nuclear β‐catenin was carried out. To define the diagnostic algorithm the tumours were first stratified according to their MLH1 expression. Loss of MLH1 expression was correlated significantly with a very low risk of distant metastases (5.3%; P = 0.00003). In MLH1‐positive cases, combined high scores of CD133 and β‐catenin were associated with a very high rate of distant metastases (94.4%), whereas the risk was intermediate for carcinomas with either low CD133 and/or low β‐catenin expression ( P = 0.0007). A validation study using an independent set of 68 right‐sided CC specimens showed a clear trend towards risk stratification according to the algorithm; however, sample sizes were small, and associations were not statistically significant. Conclusions: By the use of three markers, this algorithm allowed identification of subgroups of right‐sided CC patients with extremely high and extremely low risk of distant metastases.