A simplified two-marker immunohistochemistry strategy for Lynch syndrome screening in endometrial cancer patients

Ala Aiob, Yeo Rae Kim, Kidong Kim, Hyojin Kim, Yong Beom Kim, Duck Woo Kim, Jae Hong No, Soo Hyun Seo, Dong Hoon Suh, Kyoung Un Park

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective To examine the efficacy of MSH6 and PMS2 immunohistochemistry (IHC) as a screening method for Lynch syndrome in endometrial cancer patients. Methods Through multidisciplinary discussions, an institutional MSH6 and PMS2 IHC-initiated cascade test (MSH6, PMS2 IHC→microsatellite instability [MSI] assay→germline mismatch repair [MMR] gene sequencing) was developed to screen for Lynch syndrome in endometrial cancer patients. Testing was performed on a consecutive cohort of 218 newly diagnosed endometrial cancer patients who underwent surgery at a tertiary hospital in the Republic of Korea between August 2018 and December 2020. The number of MMR deficiencies (MSH6 or PMS2 loss in IHC) and results of subsequent tests (MSI assay and germline MMR gene sequencing) were examined. Results MMR deficiency was detected in 52 of the 218 patients (24.0%). Among these 52 patients, 34 (65.0%) underwent MSI testing, of which 31 (91.0%) exhibited high MSI. Of the 31 patients with MSI-high status, 15 (48.0%) underwent germline MMR gene sequencing. Subsequently, Lynch syndrome was diagnosed in five patients (33.0%). Conclusion Lynch syndrome screening using MSH6 and PMS2 IHC-initiated cascade testing is a viable strategy in the management of endometrial cancer. A simplified strategy (MSH6 and PMS2 IHC→germline MMR gene sequencing) was proposed because most women with MMR deficiencies exhibited high MSI.

Original languageEnglish
Pages (from-to)537-544
Number of pages8
JournalObstetrics and Gynecology Science
Volume66
Issue number6
DOIs
StatePublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023 Korean Society of Obstetrics and Gynecology. All Rights Reserved.

Keywords

  • G-T mismatch-binding protein
  • Immunohistochemistry
  • Lynch syndrome II
  • Mass screening

Fingerprint

Dive into the research topics of 'A simplified two-marker immunohistochemistry strategy for Lynch syndrome screening in endometrial cancer patients'. Together they form a unique fingerprint.

Cite this