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Pattern of hMLH1, hMSH2 and hMSH6 expressions and clinical characteristics in malaysian colorectal carcinoma cases

Aims To evaluate the pattern of microsatellite instability (MSI) and the clinical characteristics of colorectal carcinomas in a cohort of multi-ethnic patients in Malaysia. Methods We reviewed 299 patients with colorectal carcinoma (CRC). The histological slides were reviewed and immunohistochemical staining with hMLH1, hMSH2 and hMSH6 was performed. Results There was a preponderance of male to female patients (1.3:1). The age of patients ranged from 27 to 91 years with the mean of 59.9 years. 205/299 cases were left sided lesions (68.6%). MSI was found in 42 of 299 patients (14.0%). Single hMLH1 loss was seen in a majority of cases (59.5%) followed by hMSH6 (14.3%) and hMSH2 (4.8%). Nine cases (21.4%) had a combination of protein losses. MSI sporadic CRC were significantly localised to the right side ( p  = 0.001), associated with poor differentiation ( p p  = 0.005). Patients also gave a history of previous or synchronous malignancy ( p  = 0.026). There was no significant correlation with sex, age, stage, growth pattern or host response. Conclusion 14.0% of patients with sporadic colorectal carcinomas in the multiethnic cohort in Malaysia were found to have microsatellite instability. These tumours had distinct clinical, pathological and biological features.