Incidence and detection of high microsatellite instability in colorectal cancer in a Chinese population: a meta-analysis

Journal of Gastrointestinal Oncology

article

Congjun Zhang¹  Hongguang Ding²  Shijun Sun³  Zhonghua Luan⁴  Guoyan Liu⁵  Zhi Li⁸ 

[1] Department of Oncology, The First Affiliated Hospital of Anhui Medical University;Department of General Surgery, QingdaoMunicipal Hospital;The Molecular Diagnostic Center, Zhongshan City People’s Hospital;Department ofPathology, Yuncheng Central Hospital;Department of Gastrointestinal Surgery, Zhongshan Hospital of Xiamen University;Institute of Gastrointestinal Oncology, Medical College of Xiamen University;School of Pharmaceutical SciencesXiamen University;Department of Pathology, Guangdong Provincial Peoples’ Hospital

关键词: 2B3D NCI panel;    microsatellite instability (MSI);    MSI-high (MSI-H) cancer;    colorectal cancer (CRC);   

DOI  :  10.21037/jgo-20-487

学科分类：肿瘤学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: The 4 most common types of DNA mutations in tumors are single-nucleotide variations, insertion-deletion, fusion, and copy number variations. This is followed by microsatellite instability (MSI), which is known to trigger the development of MSI-high (MSI-H) cancer and is responsible for 300,000 new cases of cancer per year in China. We aim to conduct a meta-analysis based on a comparison between the positive rates of the National Cancer Institute (NCI) panel (also known as 2B3D NCI panel) and mononucleotide panels for the diagnosis of MSI in the Chinese population. Methods: In the present meta-analysis, we searched the PubMed, Embase, Web of Science, CNKI, Wanfang, CQVIP, and CBM databases. MSI diagnosis studies by PCR and capillary electrophoresis were included to compare the incidence of MSI-H in colorectal cancer obtained from panels with different microsatellite markers. Egger’s bias test was used to assess risk of bias. Results: Seventeen articles were included, which used the Newcastle-Ottawa Scale (NOS) scale for quality evaluation. The NOS scores of the included documents were ≥7 points, and the quality of the documents met the requirements. The incidence of MSI-H detected by the 2B3D NCI panel was 13.5% [95% confidence interval (CI): 10.8–16.4, I2 =52.321%, P=0.026, n=10 studies including 2,681 participants], the incidence of MSI-H detected by the mononucleotide panels was 10.6% (95% CI: 7.1–14.7, I2 =81.147%, P=0.000, n=7 studies including 3,249 participants). This indicates that, in the Chinese population, the 2B3D NCI panel can detect 27.4% more MSI-H cancers than the mononucleotide panels, 54.7% more MSI-H cancers than the panel of 6 mononucleotides, and its sensitivity is comparable to that of Promega. Conclusions: The findings of the meta-analysis demonstrated that, using the 2B3D NCI panel for MSI detection can avoid the underestimation of the incidence MSI-H in colorectal cancer and can be considered the most suitable panel for MSI detection in the Chinese population. The inclusion of only published data might be a potential source of publication bias.

【 授权许可】

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