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High microsatellite instability predicts good prognosis in intestinal‐type gastric cancers
Author(s) -
Kim Hyunki,
An Ji Yeong,
Noh Sung Hoon,
Shin Sung Kwan,
Lee Yong Chan,
Kim Hoguen
Publication year - 2011
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2010.06487.x
Subject(s) - microsatellite instability , medicine , cancer , signet ring cell , gastroenterology , hazard ratio , stromal cell , antrum , stomach , oncology , pathology , microsatellite , adenocarcinoma , biology , gene , allele , confidence interval , biochemistry
Abstract Background and Aim: A subset of gastric cancers showed high microsatellite instability (MSI‐H). The reported clinicopathological features of MSI‐H gastric cancers are heterogeneous, and specific factors associated with prognosis have not been identified. Methods: We analyzed the clinicopathological characteristics and prognostic factors in a large series (161 cases) of MSI‐H gastric cancers, and compared the results to 315 cases of microsatellite‐stable or low microsatellite‐instable gastric cancers. Results: The frequency of MSI‐H gastric cancers was 9% (161/1786). MSI‐H gastric cancers have distinct clinicopathological features, including female sex, older age, antral location, well‐to‐moderate differentiation, intestinal‐type Lauren classification, expanding‐type Ming classification, a non‐signet‐ring cell component, the presence of a mucinous component, a moderate‐to‐severe lymphoid stromal reaction, and a lower tumor stage. The MSI‐H phenotype was associated with better prognosis ( P = 0.044), and male sex ( P = 0.035, hazard ratios [HR]: 0.23), intestinal‐/mixed‐type Lauren classification ( P < 0.001, HR: 0.09) and lower tumor stages (1 and 2, P = 0.001, HR: 0.08) were independently‐favorable prognostic factors. Conclusions: With unique clinicopathological features, intestinal‐type MSI‐H gastric cancers are associated with good prognosis and can be classified as a different subset of gastric cancers.