A Model for Predicting DNA Mismatch Repair-deficient Colorectal Cancer

Abstract

Background/Aim: Identifying patients with DNA mismatch repair-deficient (dMMR) colorectal cancer (CRC) is vital to improve treatment and identify patients with Lynch syndrome (LS). We developed a prediction model for dMMR CRC using clinicopathologic features. Patients and Methods: We reviewed the medical records of 1,147 patients who underwent resection of stage I-IV CRC in whom universal screening for LS using immunohistochemistry for MMR proteins had performed. Univariate and multivariate logistic regression analyses were used to build a prediction model of dMMR CRC. Results: The prevalence of dMMR CRC was 5.2%. Age (≥75 years), tumor location (right-sided colon), main histologic features (poor differentiation), maximum tumor size (≥65 mm), and stage (I/II) were independent significant variables related to dMMR. We created a formula for predicting the likelihood of dMMR, and the probability ranged from 0.2% to 83%. Conclusion: dMMR CRC can be identified efficiently using clinicopathologic features obtained in daily clinical practice.

Potential predictors for CDX2 expression loss and mismatch repair deficiency in colorectal cancer

“…Fujiyosi et al and Chikanati et al made a prediction model for Japanese patients. In Asia, the incidence of dMMR/MSI is 4%–5%, in contrast to Western countries where the incidence is 10%–15%, so the sample could be different than our sample [ 37 ]. Jenkins et al developed the “MsPath” model for patients younger than 50 years of age.…”

“…Positive potential predictors for dMMR in CRC are CRC in ascending colon and CDX2 expression loss while CRC in rectum is negative potential predictor. According to the literature, there are five published prediction models for dMMR/MSI in CRC [37][38][39][40][41]. Fujiyosi et al and Chikanati et al made a prediction model for Japanese patients.…”