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Vol.48, No.6, 2014
Current Issue
Archive (2009~
Archive-the Korean Journal of Pathology(1967~2008)
Archive-the Korean Journal of Cytopathology(1990~2008)
Most Read Articles
  Vol.43, No.5:428-434, October 2009
Original articles
Clinicopathologic Characteristics of Left-Sided Colon Cancers with High Microsatellite Instability

Sang Kyum Kim, Junjeong Choi, Hyun Ki Kim, Young Nyun Park, Si Young Song, Hoguen Kim

Department of Pathology, Yonsei University College of Medicine

Background : High microsatellite instability (MSI-H) colorectal carcinomas (CRCs) with numerous
mutations in the microsatellite sequence are characterized by a right-sided preponderance,
frequent peritumoral and intratumoral lymphocytic infiltration, and frequent mucin production.
However, no study has correlated anatomic site and type of genetic changes with clinicopathologic

Methods : We analyzed the histopathologic features of 135 MSI-H CRCs and
compared them to 140 microsatellite stable (MSS) CRCs. Histopathologic changes in MSI-H
were further analyzed according to anatomic sites and genetic changes.

Results : MSI-H CRCs
showed previously reported clinicopathologic findings; a right-sided preponderance, an increased
number of mucinous carcinomas, and peritumoral lymphoid reactions (p<0.001 for each
variable). Increased serum CEA levels showed an MSS CRC preponderance (p=0.013). We
further analyzed the histologic differences between right- and left-sided MSI-H tumors. We
found that MSI-H CRCs on both sides had similar clinicopathologic findings, except for higher
tumor stage (p=0.048) and less frequent abnormal CEA levels in left-sided MSI-H tumors
(p=0.027). We found that not all clinicopathologic features were different between hereditary
nonpolyposis colorectal cancers (HNPCCs) and sporadic MSI-H CRCs. Conclusions :
These findings indicate that MSI-H CRCs of the left colon have similar clinicopathologic characteristics
as right-sided MSI-H CRCs. We did not find any significant clinicopathological difference
between HNPCCs and sporadic MSI-H CRCs.
Key Words : Colorectal neoplasm; Microsatellite instability; Colorectal neoplasms, hereditary nonpolyposis

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