The impact of mismatch repair status and systemic inflammatory markers on radiological staging in colon cancer.

Autor:	Platt JR; Division of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom., Ansett J; Department of Cellular Pathology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom., Seligmann JF; Division of Oncology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom., West NP; Department of Cellular Pathology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.; Division of Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom., Tolan DJM; Department of Radiology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Jazyk:	angličtina
Zdroj:	The British journal of radiology [Br J Radiol] 2023 Oct; Vol. 96 (1150), pp. 20230098. Date of Electronic Publication: 2023 Jul 26.
DOI:	10.1259/bjr.20230098
Abstrakt:	Objective: Mismatch repair (MMR) deficient (dMMR) colon cancer (CC) is distinct from MMR proficient (pMMR) CC, yet the impact of MMR status on radiological staging is unclear. The purpose of this study was to investigate how MMR status impacts CC CT staging. Methods: We retrospectively compared CT staging accuracy between dMMR and pMMR CC patients undergoing curative resection. Accuracy was assessed as individual tumour (T)/nodal (N) stages and as dichotomous "statuses" (T1/2 vs T3/4; N0 vs N1/2). Patient characteristics were analysed for factors to support staging. Results: There was no significant difference in overall staging accuracy between the dMMR (44 patients) and pMMR (57 patients) groups. dMMR tumours with incorrect N stage/"status" were more likely to be overstaged than pMMR tumours (90% vs 59%; p = 0.023 for "N status"). Platelet count, CRP and neutrophil count (AUC 0.76 ( p = 0.0078), 0.75 ( p = 0.034) and 0.70 ( p = 0.044), respectively) were associated with "N status" in dMMR tumours. Conclusion: Whilst overall staging accuracy was similar between groups, incorrectly N staged dMMR tumours were more likely to be overstaged than pMMR tumours, risking inappropriate surgical or neoadjuvant treatment. We describe novel relationships between several inflammatory markers and pathological "N status" in dMMR CC, which if integrated into routine practice may improve CT staging accuracy. Advances in Knowledge: Compared to pMMR CC, dMMR CC is at significant risk of N overstaging. Platelet count, CRP and neutrophil count are higher in dMMR CC patients with nodal metastases than those without, and their role in refining clinical staging requires further investigation.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu