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Pathologe. 2010 Oct;31 Suppl 2:268-73. doi: 10.1007/s00292-010-1335-9.

[Microsatellite instability. A new predictive marker (?)].

[Article in German]

Author information

  • 1Institut für Pathologie/Zentrum für molekularpathologische Diagnostik, Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg. wolfgang.dietmaier@klinik.uni-regensburg.de

Abstract

Microsatellite instability (MSI) is a hallmark of hereditary non-polyposis colorectal cancer (HNPCC), but also occurs in about 12%-15% of sporadic colorectal cancer (CRC) where it is a consequence of an epigenetic inactivation of MLH1. High frequency MSI (MSI-H; i.e. at least two of five specified microsatellite markers show instability) was shown in a large meta-analysis and in recent trials to be a positive prognostic marker for overall survival in CRC. MSI-H or mismatch repair deficiency (MMRD) was also shown to be a marker for ineffectiveness of adjuvant 5-fluorouracil (5-FU) based chemotherapy in CRC. At present, there are no guidelines defining the need for microsatellite analysis before chemotherapy. However, studies published to date provide data suggesting that MSI-H CRC patients should not receive adjuvant chemotherapy, with the exception of patients with other factors or poor prognosis (e.g. T4 tumors, G3/G4 status, blood or lymphatic vessel invasion). MSI or MMRD testing can contribute to a more individualized therapy of CRC and should be performed prior to planned 5-FU monotherapy or adjuvant chemotherapy in a non-metastatic setting.

[PubMed - indexed for MEDLINE]
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