Lino-Silva LS, Gamboa-Domínguez A, Zúñiga-Tamayo D, Salcedo-Hernández RA, Cetina L, Cantú-de-León D. Mismatch repair protein expression and intratumoral budding in rectal cancer are associated with an increased pathological complete response to preoperative chemoradiotherapy: A case-control study. World J Clin Oncol 2018; 9(7): 133-139 [PMID: 30425938 DOI: 10.5306/wjco.v9.i7.133]
Corresponding Author of This Article
Leonardo S Lino-Silva, MSc, Academic Research, Doctor, Gastrointestinal Pathology Division, Instituto Nacional de Cancerología de México (Mexico’s National Cancer Institute), Av. San Fernando # 22, Sección XVI, Tlalpan, Mexico City 14080, Mexico. saul.lino.sil@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Nov 10, 2018; 9(7): 133-139 Published online Nov 10, 2018. doi: 10.5306/wjco.v9.i7.133
Mismatch repair protein expression and intratumoral budding in rectal cancer are associated with an increased pathological complete response to preoperative chemoradiotherapy: A case-control study
Leonardo S Lino-Silva, Armando Gamboa-Domínguez, Diego Zúñiga-Tamayo, Rosa A Salcedo-Hernández, Lucely Cetina, David Cantú-de-León
Leonardo S Lino-Silva, Surgical Pathology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Armando Gamboa-Domínguez, Diego Zúñiga-Tamayo, Surgical Pathology, Instituto Nacional de ciencias Médicas y Nutrición salvador Zubirán, Mexico City 14080, Mexico
Rosa A Salcedo-Hernández, David Cantú-de-León, Surgical Oncology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Lucely Cetina, Medical Oncology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Author contributions: Lino-Silva LS, Gamboa-Domínguez A and Zúñiga-Tamayo D contributed equally to this work; Salcedo-Hernández RA, Cetina L and Cantú-de-León D designed research, Lino-Silva LS, Gamboa-Domínguez A, Zúñiga-Tamayo D and Salcedo-Hernández RA wrote the paper.
Institutional review board statement: This work was authorized by the institutional review board of the National Cancer Institute of Mexico with the number REV/16/87.
Informed consent statement: A waiver form informed consent was provided due the retrospective nature of the study and data were collected from clinical files and pathology database.
Conflict-of-interest statement: The authors declared no potential conflicts of interest.
STROBE Statement: This study was conducted in line with the STROBE statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo S Lino-Silva, MSc, Academic Research, Doctor, Gastrointestinal Pathology Division, Instituto Nacional de Cancerología de México (Mexico’s National Cancer Institute), Av. San Fernando # 22, Sección XVI, Tlalpan, Mexico City 14080, Mexico. saul.lino.sil@gmail.com
Telephone: +52-55-34265921
Received: July 6, 2018 Peer-review started: July 6, 2018 First decision: August 6, 2018 Revised: August 18, 2018 Accepted: October 24, 2018 Article in press: October 24, 2018 Published online: November 10, 2018 Processing time: 126 Days and 9.8 Hours
Abstract
AIM
To determine whether the association of rectal adenocarcinoma with a defective-mismatch repair system (dMMR) was associated with a pathological complete response (pCR) to preoperative chemoradiotherapy.
METHODS
A case-control study was designed with the aim of determining if patients with rectal adenocarcinoma with dMMR had an associated high pCR rate in response to neoadjuvant chemoradiotherapy (nCRT).
RESULTS
Seventy-two cases with pCR were compared against 144 controls without pCR. Across 216 cases, the mean age was 56.8 years, 140 (64.8%) were men, and 63 (29.2%) demonstrated the dMMR system. The pCR was associated with G1 tumors, dMMR, the absence of vascular invasion, and low tumor budding in the pretreatment biopsy. In a multivariant analysis, the factors associated with pCR were dMMR (OR: 2.61; 95%CI: 1.355-5.040, P = 0.004) and a low degree of tumor budding (OR: 2.52; 95%CI: 1.366-4.894, P = 0.025).
CONCLUSION
We found an independent association between dMMR and a low rate of tumor budding, with a higher rate of pCR, in the basal biopsies of patients with rectal carcinoma subjected to nCRT.
Core tip: Defective Mismatch repair (dMMR) and a low number of buds in the pretreatment biopsy were independently associated with a high rate of the pathological complete response. Tumor budding and MMR status should be considered as tools to be implemented in studies that predict the pathological response to preoperative chemo-radiotherapy in rectal cancer.
