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- Title
Predictive model for high-frequency microsatellite instability in colorectal cancer patients over 50 years of age.
- Authors
Fujiyoshi, Kenji; Yamaguchi, Tatsuro; Kakuta, Miho; Takahashi, Akemi; Arai, Yoshiko; Yamada, Mina; Yamamoto, Gou; Ohde, Sachiko; Takao, Misato; Horiguchi, Shin ‐ ichiro; Natsume, Soichiro; Kazama, Shinsuke; Nishizawa, Yusuke; Nishimura, Yoji; Akagi, Yoshito; Sakamoto, Hirohiko; Akagi, Kiwamu
- Abstract
Microsatellite instability ( MSI) is an important biomarker for screening for Lynch syndrome, and also of response to immune checkpoint inhibitors. The aim of this study is to create a predictive model to determine which elderly patients with colorectal cancer ( CRC) should undergo MSI and/or immunohistochemistry testing on the basis of clinicopathological data. We analyzed a test cohort of CRC patients aged ≥50 years ( n = 2219) by multivariate logistic regression analyses to identify predictors of high-frequency MSI ( MSI-H). The created prediction model was validated in an external cohort ( n = 992). The frequency of MSI-H was 5.5% among CRC patients aged ≥ 50 years. The following five predictors of MSI-H were identified in the test cohort: female (1 point), mucinous component (2 points), tumor size ≥ 60 mm (2 points), location in proximal colon (3 points), and BRAF mutation (6 points). The area under curve ( AUC) in the receiver-operating characteristic ( ROC) analysis of this prediction model was 0.832 (95% confidence interval: 0.790-0.874). The sensitivity and specificity were 74.4% and 77.7%, respectively, for a cut-off score of 4 points. The receiver-operating characteristic curve of the validation cohort also showed an AUC of 0.856 (95% CI: 0.806-0.905). This prediction model is useful to select elderly CRC patients who should undergo MSI testing, and who may benefit from treatment with 5- FU-based adjuvant chemotherapy and cancer immunotherapy.
- Subjects
COLON cancer treatment; DIAGNOSIS of hereditary nonpolyposis colorectal cancer; CANCER in adolescence; MICROSATELLITE repeats; GENETIC mutation; BRAF genes; CANCER chemotherapy; CANCER immunotherapy
- Publication
Cancer Medicine, 2017, Vol 6, Issue 6, p1255
- ISSN
2045-7634
- Publication type
Article
- DOI
10.1002/cam4.1088