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PLoS One. 2019 Apr 19;14(4):e0215513. doi: 10.1371/journal.pone.0215513. eCollection 2019.

Microsatellite instability is inversely associated with type 2 diabetes mellitus in colorectal cancer.

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Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan.
Department of Surgery, Southern Tohoku General Hospital, Fukushima, Japan.
Hereditary Tumor Research Project, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.



Microsatellite instability (MSI) is a clonal change in the number of repeated DNA nucleotide units in microsatellites. High-frequency MSI (MSI-H) colorectal cancers (CRCs) are known to have different clinicopathological features compared with microsatellite stable (MSS) CRCs. In addition, previous studies have shown that type2 diabetes mellitus (T2DM) is a risk factor for malignant tumors including CRCs. The aim of this study was to investigate the relationship between T2DM and MSI-H colorectal cancer.


The study design is a single center, cross-sectional study. Data from a series of 936 patients with CRCs were collected and MSI status was assessed.


In total, 29 (3.1%) and 907 (96.9%) tumors were classified as having MSI-H and low-frequency microsatellite instability or being MSS (MSS), respectively. Of the 936 patients, 275 (29.6%) were associated with T2DM. One (3.4%) of the 29 MSI-H patients and 274 (30.2%) of the 907 MSS patients had T2DM. Thus, the incidence of T2DM was significantly less frequent in MSI-H compared with MSS patients (Fisher's exact test: p = 0.0007).


We conclude that MSS tumors are significantly more common than MSI-H tumors among individuals with T2DM.

Conflict of interest statement

The authors have declared that no competing interests exist.

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