Low Prevalence of Microsatellite Instability in Interval Gastric Cancers

• Published in: Digestive diseases and sciences Vol. 59; no. 2; pp. 322 - 327
• Main Authors: Choi, Hong Seok, Lee, Sun-Young, Kim, Jeong Hwan, Sung, In-Kyung, Park, Hyung Seok, Shim, Chan Sup, Jin, Choon Jo, Han, Hye Seung
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.02.2014; Springer; Springer Nature B.V
• Subjects: Aged; Analysis; Biochemistry; Cancer; Chi-Square Distribution; Development and progression; Diagnosis; Early Detection of Cancer; Endoscopy, Digestive System; Ethylenediaminetetraacetic acid; Female; Gastrectomy; Gastroenterology; Genetic aspects; Genetic Predisposition to Disease; Hepatology; Humans; Kaplan-Meier Estimate; Logistic Models; Male; Medicine; Medicine & Public Health; Microsatellite Instability; Middle Aged; Neoplasm Staging; Odds Ratio; Oncology; Oncology, Experimental; Original Article; Phenotype; Predictive Value of Tests; Prevalence; Republic of Korea - epidemiology; Risk Factors; Stomach cancer; Stomach Neoplasms - genetics; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Time Factors; Transplant Surgery; Tumor Burden; Republic of Korea; Esophagogastroduodenoscopy; Screening; Microsatellite instability; Gastric cancer
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-013-2987-0

Background and Aim Esophagogastroduodenoscopy (EGD) is recommended at 2-year intervals in countries with a high prevalence of gastric cancer. The aim of this study was to determine whether interval gastric cancers that develop within 2 years of a previous complete screening are associated with microsatellite instability (MSI). Methods Newly diagnosed gastric cancer patients who had undergone gastrectomy were included. Of these 459 patients, 177 were classified as interval gastric cancer since they were diagnosed within 2 years of a previous EGD. Noninterval gastric cancer patients were subclassified into 65 patients who underwent previous EGD between the past 2 and 10 years and 217 patients without EGD during the last 10 years. Analysis for MSI was conducted using two mononucleotide and three dinucleotide markers. Results MSI was found more frequently in noninterval gastric cancers than in interval gastric cancers ( p  = 0.009). Interval gastric cancers were associated with a higher prevalence of early gastric cancer ( p  = 0.006), smaller size ( p  < 0.001), and lower TNM stages ( p  = 0.006). On logistic regression analysis, noninterval gastric cancers were related to MSI ( p  = 0.010) and larger size (≥4 cm) ( p  = 0.009). Subjects with interval gastric cancer showed better survival than those with noninterval gastric cancer ( p  = 0.006). Conclusions During a 2-year screening interval, noninterval gastric cancers tend to be larger, more advanced, and associated with MSI. Biannual EGD screening is effective for detecting small gastric cancers at an early stage, but is not useful in detecting gastric cancers with MSI.