TY - JOUR
T1 - Colorectal carcinomas with isolated loss of PMS2 staining by immunohistochemistry
AU - Alpert, Lindsay
AU - Pai, Reetesh K.
AU - Srivastava, Amitabh
AU - McKinnon, Wendy
AU - Wilcox, Rebecca
AU - Yantiss, Rhonda K.
AU - Arcega, Ramir
AU - Wang, Hanlin L.
AU - Robert, Marie E.
AU - Liu, Xiuli
AU - Pai, Rish K.
AU - Zhao, Lei
AU - Westerhoff, Maria
AU - Hampel, Heather
AU - Kupfer, Sonia
AU - Setia, Namrata
AU - Xiao, Shu Yuan
AU - Hart, John
AU - Frankel, Wendy L.
N1 - Publisher Copyright:
© 2018 College of American Pathologists. All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - Context.-Isolated loss of PMS2 staining is an uncommon immunophenotype in colorectal carcinomas, accounting for approximately 4% of tumors with microsatellite instability. Limited information regarding these tumors is available in the literature. Objective.-To compare the clinicopathologic features of colorectal carcinomas with isolated PMS2 loss by immunohistochemistry to those with other forms of mismatch repair deficiency. Design.-Ninety-three colorectal carcinomas with isolated PMS2 loss by immunohistochemistry and 193 with other forms of mismatch repair deficiency were identified. Forty (43%) of the isolated PMS2 loss cases and 35 control cases (18%) had a known germline mutation or a clinical diagnosis of Lynch syndrome. Results.-Overall, isolated PMS2-loss tumors occurred in significantly younger patients (P <.001) and in fewer female patients (P =.006). These tumors were significantly less likely to be right-sided (P =.001), high-grade (P =.01), or display histologic features of microsatellite instability (P <.001). The isolated PMS2-loss group also exhibited increased odds of disease-specific death (odds ratio [OR], 3.09; 95% CI, 1.41-6.85; P =.007). When the analysis was restricted to germline mutation/Lynch syndrome cases and controls, no significant differences were detected for age, sex, tumor location, tumor grade, histologic features, or distant metastases, although a trend toward increased odds of disease-specific death in the isolated PMS2-loss group was evident (OR, 3.87; 95% CI, 0.89-27.04; P =.10). Conclusions.-Unusual clinicopathologic features observed in colorectal carcinomas with isolated PMS2 loss are likely related to the high proportion of cases caused by germline mutations. Isolated PMS2-loss tumors may demonstrate more aggressive behavior than other tumors with microsatellite instability, but larger studies are needed to investigate that possibility further.
AB - Context.-Isolated loss of PMS2 staining is an uncommon immunophenotype in colorectal carcinomas, accounting for approximately 4% of tumors with microsatellite instability. Limited information regarding these tumors is available in the literature. Objective.-To compare the clinicopathologic features of colorectal carcinomas with isolated PMS2 loss by immunohistochemistry to those with other forms of mismatch repair deficiency. Design.-Ninety-three colorectal carcinomas with isolated PMS2 loss by immunohistochemistry and 193 with other forms of mismatch repair deficiency were identified. Forty (43%) of the isolated PMS2 loss cases and 35 control cases (18%) had a known germline mutation or a clinical diagnosis of Lynch syndrome. Results.-Overall, isolated PMS2-loss tumors occurred in significantly younger patients (P <.001) and in fewer female patients (P =.006). These tumors were significantly less likely to be right-sided (P =.001), high-grade (P =.01), or display histologic features of microsatellite instability (P <.001). The isolated PMS2-loss group also exhibited increased odds of disease-specific death (odds ratio [OR], 3.09; 95% CI, 1.41-6.85; P =.007). When the analysis was restricted to germline mutation/Lynch syndrome cases and controls, no significant differences were detected for age, sex, tumor location, tumor grade, histologic features, or distant metastases, although a trend toward increased odds of disease-specific death in the isolated PMS2-loss group was evident (OR, 3.87; 95% CI, 0.89-27.04; P =.10). Conclusions.-Unusual clinicopathologic features observed in colorectal carcinomas with isolated PMS2 loss are likely related to the high proportion of cases caused by germline mutations. Isolated PMS2-loss tumors may demonstrate more aggressive behavior than other tumors with microsatellite instability, but larger studies are needed to investigate that possibility further.
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U2 - 10.5858/arpa.2017-0156-OA
DO - 10.5858/arpa.2017-0156-OA
M3 - Article
C2 - 29336605
AN - SCOPUS:85044509523
SN - 0003-9985
VL - 142
SP - 523
EP - 528
JO - Archives of Pathology and Laboratory Medicine
JF - Archives of Pathology and Laboratory Medicine
IS - 4
ER -