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Elsayed I, Geraghty R, Mekki SO, Mohamedani AA, Ahern S, Salim OEH, Khalil BBM, Abdelrahim S, Suliman SH, Elhassan MMA, Salah SO, Salih ME, Widatalla AH, Abdelhamed OS, Wang X, Ryan ÉJ, Winter D, Bakhiet S, Sheahan K. Evaluating utility and feasibility of mismatch repair testing of colorectal cancer patients in a low-middle-income country. Sci Rep 2022; 12:10998. [PMID: 35768447 PMCID: PMC9243080 DOI: 10.1038/s41598-022-14644-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/09/2022] [Indexed: 12/24/2022] Open
Abstract
Molecular pathology services for colorectal cancer (CRC) in Sudan represent a significant unmet clinical need. In a retrospective cohort study involving 50 patients diagnosed with CRC at three major medical settings in Sudan, we aimed to outline the introduction of a molecular genetic service for CRC in Sudan, and to explore the CRC molecular features and their relationship to patient survival and clinicopathological characteristics. Mismatch repair (MMR) and BRAF (V600E) mutation status were determined by immunohistochemistry. A mismatch repair deficient (dMMR) subtype was demonstrated in 16% of cases, and a presumptive Lynch Syndrome (LS) diagnosis was made in up to 14% of patients. dMMR CRC in Sudan is characterized by younger age at diagnosis and a higher incidence of right-sided tumours. We report a high mortality in Sudanese CRC patients, which correlates with advanced disease stage, and MMR status. Routine MMR immunohistochemistry (with sequential BRAF mutation analysis) is a feasible CRC prognostic and predictive molecular biomarker, as well as a screening tool for LS in low-middle-income countries (LMICs).
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Affiliation(s)
- Inas Elsayed
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Cancer Genomics Research Center, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Big Data Research Institute, China Pharmaceutical University, Nanjing, 211198, China.,Department of Pharmacology, Faculty of Pharmacy, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Robert Geraghty
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Salwa O Mekki
- Department of Histopathology, Soba University Hospital, Khartoum, Sudan
| | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Susan Ahern
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland
| | - Omer E H Salim
- Department of Surgery, Soba University Hospital, Khartoum, Sudan
| | - Balgis B M Khalil
- Department of Histopathology, Ibn Sina Specialized Hospital, Khartoum, Sudan
| | - Sawsan Abdelrahim
- Department of Histopathology, Soba University Hospital, Khartoum, Sudan
| | | | - Moawia M A Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | - Salah O Salah
- Department of Oncology, Khartoum Oncology Hospital, Khartoum, Sudan
| | - Mohamed E Salih
- Department of Surgery, Faculty of Medicine, University of Gezira, P.O. Box: 20, Wad Madani, Sudan
| | | | | | - Xiaosheng Wang
- Biomedical Informatics Research Lab, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Cancer Genomics Research Center, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Big Data Research Institute, China Pharmaceutical University, Nanjing, 211198, China
| | - Éanna J Ryan
- Department of Surgery, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland
| | - Des Winter
- Department of Surgery, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Salih Bakhiet
- Hull Royal Infirmary, Hull University Hospital NHS Trust, Hull, East Yorkshire, UK
| | - Kieran Sheahan
- Department of Pathology, Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin 4, Ireland. .,School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
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