Evaluation of Mismatch Repair Protein Expression and Its Association with Histopathological Features in Colorectal Carcinoma: A Prospective Study

Enoch Raju Kanikella; Srujana Raparthi; Pradeep Masa

doi:10.37022/wjcmpr.v8i3.454

Authors

Enoch Raju Kanikella Associate Professor, Department of Pathology, Raniganj Institute of Medical Sciences, Raniganj, West Bengal, India.
Raparthi Srujana Assistant Professor, Department of Pathology, Government Medical College, Mahabubnagar, Telangana, India
Masa Pradeep Associate Professor, Department of Pathology, Kerala Medical College, Mangode, Keralam, India.

Abstract

Background: Mismatch repair deficiency represents a biologically distinct subset of colorectal carcinoma with diagnostic and therapeutic significance. The present study aimed to assess mismatch repair (MMR) protein expression and its correlation with histopathological features.

Methods: This prospective study included 150 colorectal carcinoma resection specimens, which were evaluated for MLH1, PMS2, MSH2, and MSH6 expression using immunohistochemistry. The clinicopathological features were analysed and compared between deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR) tumours.

Results: A total of 30 cases (20.0%) showed dMMR. The most frequent pattern was loss of MLH1/PMS2 expression (60.0% of dMMR cases), followed by loss of MSH2/MSH6 expression. High levels of tumour-infiltrating lymphocytes (TILs) were significantly more common in dMMR than in pMMR tumours (40.0% vs. 16.7%; OR = 3.33; p = 0.005) and were independently associated with dMMR (aOR = 3.85; p = 0.005). Positive but statistically non-significant adjusted associations were observed for right-sided tumour location and mucinous/medullary morphology.

Conclusion: dMMR was identified in one-fifth of colorectal carcinoma cases and was most strongly associated with prominent lymphocytic infiltration.

Keywords:

Colorectal carcinoma, mismatch repair, dMMR, immunohistochemistry, tumour-infiltrating lymphocytes

DOI

https://doi.org/10.37022/wjcmpr.v8i3.454

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