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Immunohistochemistry as First-line Screening for Detecting Colorectal Cancer Patients at Risk for Hereditary Nonpolyposis Colorectal Cancer Syndrome: A 2-antibody Panel May be as Predictive as a 4-antibody Panel

Shia, Jinru MD*; Tang, Laura H. MD, PhD*; Vakiani, Efsevia MD, PhD*; Guillem, Jose G. MD; Stadler, Zsofia K. MD; Soslow, Robert A. MD*; Katabi, Nora MD*; Weiser, Martin R. MD; Paty, Philip B. MD; Temple, Larissa K. MD; Nash, Garrett M. MD; Wong, W. Douglas MD; Offit, Kenneth MD, MPH; Klimstra, David S. MD*

Erratum

Immunohistochemistry as First-line Screening for Detecting Colorectal Cancer Patients at Risk for Hereditary Nonpolyposis Colorectal Cancer Syndrome: A 2-antibody Panel May be as Predictive as a 4-antibody Panel–Erratum.

The article that appeared on page 1639 of the November 2009 issue of the journal had incorrect percentages in Table 1 , in the columns, “Prospective Series” and “Retrospective Series”. The correct table is shown below with the correct percentages in each of these columns.

An additional error is in the Results section, in the 1st line of the 1st paragraph. The 26% should be 30%. 1

The American Journal of Surgical Pathology. 34(3):432, March 2010.

The American Journal of Surgical Pathology: November 2009 - Volume 33 - Issue 11 - p 1639-1645
doi: 10.1097/PAS.0b013e3181b15aa2
Original Articles
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Erratum

The utility of immunohistochemical detection of DNA mismatch repair proteins in screening colorectal cancer for hereditary nonpolyposis colorectal cancer (HNPCC) is being widely investigated. Currently, in both research and clinical settings, a 4-antibody panel that includes the 4 most commonly affected proteins (MLH1, MSH2, MSH6, and PMS2) is being used generally. On the basis of the biochemical properties of these proteins, we hypothesized that a 2-antibody panel, comprising MSH6 and PMS2, would be sufficient to detect abnormalities in all 4 proteins. We tested this hypothesis on a series of 232 colorectal carcinoma samples derived from 2 patient cohorts: (1) a prospectively accrued series of patients who were judged to carry a higher-than-average risk for HNPCC based on the revised Bethesda guidelines (n=190); and (2) a retrospective series of patients who were 40 years of age or younger (n=42). Immunohistochemical stains were regarded as negative (protein lost), when there was no nuclear labeling in tumor cells (with positive internal control). Overall, 70 of the 232 tumors demonstrated loss of at least one protein. The most common abnormality was concurrent loss of MLH1 and PMS2 (observed in 17% of the cases), followed by concurrent loss of MSH2 and MSH6 (6%). All MLH1 and MSH2-abnormal cases were also abnormal for PMS2 and MSH6, respectively, whereas 9 of 50 (18%) PMS2 and 6 of 20 (30%) MSH6-abnormal cases showed only isolated loss of PMS2 or MSH6 (with normal staining for MLH1 and MSH2). As such, our findings provide evidence that a 2-antibody panel (PMS2 and MSH6) is as effective as the current 4-antibody panel in detecting DNA mismatch repair protein abnormalities. Such a cost-effective approach carries significant implication, as immunohistochemistry is being widely used as first-line screening for HNPCC.

Departments of *Pathology

Surgery

Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY

Correspondence: David S. Klimstra, MD, Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (e-mail: Klimstrd@mskcc.org).

Presented at the 97th annual meeting of the United States and Canadian Academy of Pathology, Denver, CO, March 1-7, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.