Low frequency of mismatch repair deficiency in gallbladder cancer.


Journal

Diagnostic pathology
ISSN: 1746-1596
Titre abrégé: Diagn Pathol
Pays: England
ID NLM: 101251558

Informations de publication

Date de publication:
08 May 2019
Historique:
received: 09 12 2018
accepted: 16 04 2019
entrez: 10 5 2019
pubmed: 10 5 2019
medline: 26 11 2019
Statut: epublish

Résumé

DNA mismatch repair (MMR) deficiency is a major pathway of genomic instability in cancer. It leads to the accumulation of numerous mutations predominantly at microsatellite sequences, a phenotype known as microsatellite instability (MSI). MSI tumors have a distinct clinical behavior and commonly respond well to immune checkpoint blockade, irrespective of their origin. Data about the prevalence of MSI among gallbladder cancer (GBC) have been conflicting. We here analyzed a well-characterized cohort of 69 Western-world GBCs. We analyzed the mononucleotide MSI marker panel consisting of BAT25, BAT26, and CAT25 to determine the prevalence of MMR deficiency-induced MSI. MSI was detected in 1/69 (1.4%) of analyzed GBCs. The detected MSI GBC had a classical histomorphology, i.e. of acinar/tubular/glandular pancreatobiliary phenotype, and showed nuclear expression of all four MMR proteins MLH1, MSH2, MSH6, and PMS2. The MSI GBC patient showed a prolonged overall survival, despite having a high tumor stage at diagnosis. The patient had no known background or family history indicative of Lynch syndrome. Even though the overall number of MSI tumors is low in GBC, the potentially therapeutic benefit of checkpoint blockade in the respective patients may justify MSI analysis of GBC.

Sections du résumé

BACKGROUND BACKGROUND
DNA mismatch repair (MMR) deficiency is a major pathway of genomic instability in cancer. It leads to the accumulation of numerous mutations predominantly at microsatellite sequences, a phenotype known as microsatellite instability (MSI). MSI tumors have a distinct clinical behavior and commonly respond well to immune checkpoint blockade, irrespective of their origin. Data about the prevalence of MSI among gallbladder cancer (GBC) have been conflicting. We here analyzed a well-characterized cohort of 69 Western-world GBCs.
METHODS METHODS
We analyzed the mononucleotide MSI marker panel consisting of BAT25, BAT26, and CAT25 to determine the prevalence of MMR deficiency-induced MSI.
RESULTS RESULTS
MSI was detected in 1/69 (1.4%) of analyzed GBCs. The detected MSI GBC had a classical histomorphology, i.e. of acinar/tubular/glandular pancreatobiliary phenotype, and showed nuclear expression of all four MMR proteins MLH1, MSH2, MSH6, and PMS2. The MSI GBC patient showed a prolonged overall survival, despite having a high tumor stage at diagnosis. The patient had no known background or family history indicative of Lynch syndrome.
CONCLUSIONS CONCLUSIONS
Even though the overall number of MSI tumors is low in GBC, the potentially therapeutic benefit of checkpoint blockade in the respective patients may justify MSI analysis of GBC.

Identifiants

pubmed: 31068195
doi: 10.1186/s13000-019-0813-5
pii: 10.1186/s13000-019-0813-5
pmc: PMC6506936
doi:

Substances chimiques

MLH1 protein, human 0
MutL Protein Homolog 1 EC 3.6.1.3

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

36

Subventions

Organisme : Deutsche Forschungsgemeinschaft
ID : SFB/TR 209
Organisme : European Union Horizon 2020
ID : 667273

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Auteurs

Benjamin Goeppert (B)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany. benjamin.goeppert@med.uni-heidelberg.de.
Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany. benjamin.goeppert@med.uni-heidelberg.de.

Stephanie Roessler (S)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.
Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.

Marcus Renner (M)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.

Moritz Loeffler (M)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.

Stephan Singer (S)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.

Melina Rausch (M)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.

Thomas Albrecht (T)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.
Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.

Arianeb Mehrabi (A)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of General Visceral and Transplantation Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany.

Monika Nadja Vogel (MN)

Diagnostic and Interventional Radiology, Thoraxklinik at University Hospital of Heidelberg, Heidelberg, Germany.

Anita Pathil (A)

Department of Internal Medicine IV, Gastroenterology and Hepatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany.

Elena Czink (E)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Bruno Köhler (B)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Christoph Springfeld (C)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Christian Rupp (C)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

Karl Heinz Weiss (KH)

Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.
Department of Internal Medicine IV, Gastroenterology and Hepatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany.

Peter Schirmacher (P)

Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, Heidelberg, Germany.
Liver Cancer Center Heidelberg (LCCH), Heidelberg, Germany.

Magnus von Knebel Doeberitz (M)

Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.

Matthias Kloor (M)

Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.

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