Status of testing for high-level microsatellite instability/ deficient mismatch repair in colorectal carcinoma
Menée aux Etats-Unis à partir des données du registre national des cancers portant sur 152 993 adultes atteints d'un adénocarcinome colorectal invasif diagnostiqué entre 2010 et 2012 (âge moyen : 66,9 ans), cette étude analyse sur cette période l'évolution de l'utilisation des tests recherchant une déficience du système MMR, puis identifie les facteurs prédictifs associés à cette utilisation
Determining the microsatellite instability (MSI) status of colorectal carcinoma (CRC) and other tumor types has recently increased in importance for patient management and prevention strategies.1,2 High-level MSI (MSI-H)/deficient mismatch repair (dMMR) (widely used alternative terminologies) has long been known to be a hallmark of Lynch syndrome. The identification of this small subset of patients (approximately 3% of patients with CRC) has major implications for prevention in blood relatives and for avoiding metachronous tumors in patients who have a first Lynch-associated tumor. Preoperative decisions can be made about prophylactic surgery at the initial treatment, including abdominal colectomy and hysterectomy with bilateral salpingo-oophorectomy after childbearing is completed.
JAMA Oncology , commentaire, 2016