Journal
JOURNAL OF GASTROINTESTINAL CANCER
Volume 52, Issue 1, Pages 263-268Publisher
SPRINGER
DOI: 10.1007/s12029-020-00395-y
Keywords
Lynch syndrome; Mismatch repair; Immunohistochemistry; Adenoma; Polyp; Iran
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Funding
- Mashhad University of Medical Sciences [951047]
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The study aimed to assess the prevalence of mismatch repair deficiency in patients under the age of 50 with advanced adenomatous polyps, but no loss of MMR protein expression was identified in the early-onset advanced colorectal adenomas examined.
Background Lynch syndrome (LS) increases the risk of many types of cancer, mainly colorectal cancer (CRC). The purpose of this study was to assess the prevalence of mismatch repair (MMR) deficiency in patients under the age of 50 with advanced adenomatous polyps, aiming at an early diagnosis of LS. Methods This retrospective, cross-sectional study included eligible patients with advanced adenomas diagnosed <= 50 years of age registered between April 2014 and February 2017 at three pathology centers in Mashhad. Pathological records were reviewed, and colon tissue specimens were analyzed by immunohistochemistry (IHC) staining to identify proteins which serve as markers for LS as they are related to loss of MMR gene (MLH1, MSH2, MSH6, and PMS2) expression. Results Of 862 consecutive patients, a total of 50 adenomas (54% males, 46% females of mean age 41.24 +/- 6.5) met the eligibility criteria. Of the adenomas examined, 20 (40%) had a tubulovillous component, 34 (68%) had high-grade dysplasia, and 30 (60%) had were larger than 10 mm protrusions. None of the patients had loss of MMR protein expression. Conclusion No individual with MMR genetic disorder was identified by IHC screening of early-onset advanced colorectal adenomas. This strategy is therefore not an effective strategy for detecting MMR mutation carriers.
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