Proposal for a New Histomolecular Diagnostic Algorithm for Colon Carcinoma in Cuba
Keywords:
Inestabilidad Microsatelital, Inmunohistoquímica, Colon, Cuba.Abstract
Introduction: The detection of microsatellite instability by immunohistochemistry has important clinical implications: the prediction of response to chemotherapy, the possibility of using immunotherapy agents, and as a screening tool for Lynch syndrome.
Objective: To propose a histomolecular diagnostic algorithm based on the characteristics of colon adenocarcinoma and the involvement of DNA mismatch repair system proteins.
Methods: A cross-sectional descriptive study was conducted in the Department of Pathology at Hermanos Ameijeiras Clinical-Surgical Teaching Hospital during the 2022-2023 period. Protein expression (MLH1, MSH2, MSH6, and PMS2) was evaluated using immunohistochemistry in 48 cases of colon adenocarcinoma. The variables analyzed included demographic and pathological variables.
Results: Significant differences were found related to microsatellite instability, tumor location in the right colon (p = 0.010), and moderate degree of differentiation (p = 0.040). In contrast, histological type and lymphocytic infiltrate appear to be unrelated to the presence or absence of instability. However, angioinvasion (p = 0.030) emerged as a parameter that showed a significant association.
Conclusions: The implementation of an immunohistochemistry-based diagnostic algorithm for the detection of microsatellite instability in patients with colon adenocarcinoma significantly differentiates patients with sporadic colon cancer from hereditary colon cancer (Lynch syndrome) and thus guides the selection of appropriate therapy.
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Copyright (c) 2025 María Del Consuelo López Sánchez, Carlos Dominguez Alvarez, Marisol Rodríguez Touceiro, Gissel García Menéndez
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