Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)

Purpose. Microsatellite instability (MSI) caused by mismatch repair protein (MMRP) deficiency is detected in 15% of sporadic colorectal cancers (CRCs). Our aim is to investigate the frequency of MMRP deficiency in young CRC patients, using immunohistochemical analysis. Methods. This study targeted c...

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Main Authors: Bayan Maraqa, Ghassan Al-Shbool, Osama Abu-Shawer, Mamoun Souleiman, Osama Alshakhatreh, Amal Al-Omari, Hadeel Abdelkhaleq, Ayat Taqash, Maysa Al-Hussaini
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/5632984
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author Bayan Maraqa
Ghassan Al-Shbool
Osama Abu-Shawer
Mamoun Souleiman
Osama Alshakhatreh
Amal Al-Omari
Hadeel Abdelkhaleq
Ayat Taqash
Maysa Al-Hussaini
author_facet Bayan Maraqa
Ghassan Al-Shbool
Osama Abu-Shawer
Mamoun Souleiman
Osama Alshakhatreh
Amal Al-Omari
Hadeel Abdelkhaleq
Ayat Taqash
Maysa Al-Hussaini
author_sort Bayan Maraqa
collection DOAJ
description Purpose. Microsatellite instability (MSI) caused by mismatch repair protein (MMRP) deficiency is detected in 15% of sporadic colorectal cancers (CRCs). Our aim is to investigate the frequency of MMRP deficiency in young CRC patients, using immunohistochemical analysis. Methods. This study targeted cases of CRC at King Hussein Cancer Center from 2004 until 2012 in patients 45 years of age or younger at the time of diagnosis. Clinicopathological data was obtained from 155 patients’ records. Immunohistochemistry for MLH1, MSH2, PMS2, and MSH6 proteins was performed on paraffin-embedded tissue containing carcinoma. Results. The median age of patient at diagnosis was 38 years. A total of 29 (19%) cases showed deficient MMRP(dMMRP)expression. Loss of expression of PMS2 was seen in 17 cases, 12 cases of which showed loss of MLH1 expression. Loss of expression of MSH6 was seen in 10 cases, 9 of which showed loss of MSH2 expression. One case (3.4%) showed loss of all four MMR proteins, and another case (3.4%) showed loss of PMS2/MLH1 and MSH6. There was a significant association between abnormal MMR protein expression and tumor location proximal to splenic flexure (p value 0.000), pathologic features suggestive of microsatellite instability (p value 0.000), P53 negativity (p value 0.000), and stage (p value 0.02). Patients with dMMRP CRC appeared to have a significantly better overall survival compared to patients with proficient MMRP(pMMRP)(p value 0.02). Loss of MSH2/MSH6 was significantly associated with positive family history of cancer (p value = 0.020). Conclusions. The prevalence of dMMRP tumors in this age group appears to be similar to international literature. dMMRP tumors tends to be associated with earlier stages and better outcomes compared to pMMRP cases. dMMRP can serve as a biomarker for better prognosis. These results are of value in directing the clinical management of young patients with CRC.
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spelling doaj-art-7d40867c4f6e4c8aa012de98602953832025-08-20T02:07:12ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/56329845632984Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)Bayan Maraqa0Ghassan Al-Shbool1Osama Abu-Shawer2Mamoun Souleiman3Osama Alshakhatreh4Amal Al-Omari5Hadeel Abdelkhaleq6Ayat Taqash7Maysa Al-Hussaini8Department of Pathology, King Hussein Cancer Center, Amman, JordanMedStar Washington Hospital Center/Georgetown University, USAUniversity of Jordan School of Medicine, JordanUniversity of Jordan School of Medicine, JordanUniversity of Jordan School of Medicine, JordanOffice of Scientific Affairs and Research, King Hussein Cancer Center (KHCC), Amman, JordanOffice of Scientific Affairs and Research, King Hussein Cancer Center (KHCC), Amman, JordanOffice of Scientific Affairs and Research, King Hussein Cancer Center (KHCC), Amman, JordanDepartment of Pathology, King Hussein Cancer Center, Amman, JordanPurpose. Microsatellite instability (MSI) caused by mismatch repair protein (MMRP) deficiency is detected in 15% of sporadic colorectal cancers (CRCs). Our aim is to investigate the frequency of MMRP deficiency in young CRC patients, using immunohistochemical analysis. Methods. This study targeted cases of CRC at King Hussein Cancer Center from 2004 until 2012 in patients 45 years of age or younger at the time of diagnosis. Clinicopathological data was obtained from 155 patients’ records. Immunohistochemistry for MLH1, MSH2, PMS2, and MSH6 proteins was performed on paraffin-embedded tissue containing carcinoma. Results. The median age of patient at diagnosis was 38 years. A total of 29 (19%) cases showed deficient MMRP(dMMRP)expression. Loss of expression of PMS2 was seen in 17 cases, 12 cases of which showed loss of MLH1 expression. Loss of expression of MSH6 was seen in 10 cases, 9 of which showed loss of MSH2 expression. One case (3.4%) showed loss of all four MMR proteins, and another case (3.4%) showed loss of PMS2/MLH1 and MSH6. There was a significant association between abnormal MMR protein expression and tumor location proximal to splenic flexure (p value 0.000), pathologic features suggestive of microsatellite instability (p value 0.000), P53 negativity (p value 0.000), and stage (p value 0.02). Patients with dMMRP CRC appeared to have a significantly better overall survival compared to patients with proficient MMRP(pMMRP)(p value 0.02). Loss of MSH2/MSH6 was significantly associated with positive family history of cancer (p value = 0.020). Conclusions. The prevalence of dMMRP tumors in this age group appears to be similar to international literature. dMMRP tumors tends to be associated with earlier stages and better outcomes compared to pMMRP cases. dMMRP can serve as a biomarker for better prognosis. These results are of value in directing the clinical management of young patients with CRC.http://dx.doi.org/10.1155/2020/5632984
spellingShingle Bayan Maraqa
Ghassan Al-Shbool
Osama Abu-Shawer
Mamoun Souleiman
Osama Alshakhatreh
Amal Al-Omari
Hadeel Abdelkhaleq
Ayat Taqash
Maysa Al-Hussaini
Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
Gastroenterology Research and Practice
title Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
title_full Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
title_fullStr Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
title_full_unstemmed Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
title_short Frequency of Mismatch Repair Protein (MMRP) Deficiency among Young Jordanians Diagnosed with Colorectal Carcinoma (CRC)
title_sort frequency of mismatch repair protein mmrp deficiency among young jordanians diagnosed with colorectal carcinoma crc
url http://dx.doi.org/10.1155/2020/5632984
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