Prediction of mismatch repair deficient biliary tract cancer: Role of morphological features and host immune response detected by routine hematoxylin‐eosin staining

Background/Purpose The objective of this study was to determine the frequency and predictors of biliary tract cancer (BTC) with deficient DNA mismatch repair (dMMR) in Japan. Methods Immunostaining and microsatellite instability analysis were performed for mismatch repair‐related proteins in tissue...

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Published in:Journal of hepato-biliary-pancreatic sciences 2021-08, Vol.28 (8), p.680-691
Main Authors: Suda, Ryuichiro, Sakai, Nozomu, Matsushita, Kazuyuki, Ishige, Takayuki, Kawasaki, Yohei, Shiko, Yuki, Furukawa, Katsunori, Mishima, Takashi, Nakadai, Eri, Ohtsuka, Masayuki
Format: Article
Language:English
Subjects:
biliary tract cancer
Cholangiocarcinoma
DNA mismatch repair
microsatellite instability
tertiary lymphoid structures
tumor infiltrating lymphocytes
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Summary:Background/Purpose The objective of this study was to determine the frequency and predictors of biliary tract cancer (BTC) with deficient DNA mismatch repair (dMMR) in Japan. Methods Immunostaining and microsatellite instability analysis were performed for mismatch repair‐related proteins in tissue specimens from 662 patients who underwent surgery for BTC between 2001 and 2017 to identify dMMR‐BTC. We compared dMMR‐BTC and proficient MMR (pMMR)‐BTC based on patient demographics, pathological features, and host immune responses characterized by the percentage of stromal tumor infiltrating lymphocytes (sTIL percentage) and tertiary lymphoid structures (TLS). Results The incidence of dMMR‐BTC was 2.3%. Significant predictors of dMMR‐BTC were its primary lesion being intrahepatic cholangiocarcinoma (odds ratio [OR] 6.34, P = .004), presence of signet ring cell component (OR 35.62, P 
ISSN:1868-6974
1868-6982
DOI:10.1002/jhbp.988