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Efficient and reproducible identification of mismatch repair deficient colon cancer: validation of the MMR index and comparison with other predictive models.


ABSTRACT:

Background

The identification of mismatch-repair (MMR) defective colon cancer is clinically relevant for diagnostic, prognostic and potentially also for treatment predictive purposes. Preselection of tumors for MMR analysis can be obtained with predictive models, which need to demonstrate ease of application and favorable reproducibility.

Methods

We validated the MMR index for the identification of prognostically favorable MMR deficient colon cancers and compared performance to 5 other prediction models. In total, 474 colon cancers diagnosed???age 50 were evaluated with correlation between clinicopathologic variables and immunohistochemical MMR protein expression.

Results

Female sex, age ?60 years, proximal tumor location, expanding growth pattern, lack of dirty necrosis, mucinous differentiation and presence of tumor-infiltrating lymphocytes significantly correlated with MMR deficiency. Presence of at least 4 of the MMR index factors identified MMR deficient tumors with 93% sensitivity and 76% specificity and showed favorable reproducibility with a kappa value of 0.88. The MMR index also performed favorably when compared to 5 other predictive models.

Conclusions

The MMR index is easy to apply and efficiently identifies MMR defective colon cancers with high sensitivity and specificity. The model shows stable performance with low inter-observer variability and favorable performance when compared to other MMR predictive models.

SUBMITTER: Joost P 

PROVIDER: S-EPMC3878549 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

Efficient and reproducible identification of mismatch repair deficient colon cancer: validation of the MMR index and comparison with other predictive models.

Joost Patrick P   Bendahl Pär-Ola PO   Halvarsson Britta B   Rambech Eva E   Nilbert Mef M  

BMC clinical pathology 20131217 1


<h4>Background</h4>The identification of mismatch-repair (MMR) defective colon cancer is clinically relevant for diagnostic, prognostic and potentially also for treatment predictive purposes. Preselection of tumors for MMR analysis can be obtained with predictive models, which need to demonstrate ease of application and favorable reproducibility.<h4>Methods</h4>We validated the MMR index for the identification of prognostically favorable MMR deficient colon cancers and compared performance to 5  ...[more]

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