{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:53:25Z","timestamp":1762300405258,"version":"3.41.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>Evaluation of mismatch repair (MMR) protein and microsatellite instability (MSI) status plays a pivotal role in the management of gastric cancer (GC) patients. In this study, we aimed to evaluate the accuracy of gastric endoscopic biopsies (EBs) in predicting MMR\/MSI status and to uncover histopathologic features associated with MSI. A multicentric series of 140 GCs was collected retrospectively, in which EB and matched surgical specimens (SSs) were available. Laur\u00e9n and WHO classifications were applied and detailed morphologic characterization was performed. EB\/SS were analyzed by immunohistochemistry (IHC) for MMR status and by multiplex polymerase chain reaction (mPCR) for MSI status. IHC allowed accurate evaluation of MMR status in EB (sensitivity: 97.3%; specificity: 98.0%) and high concordance rates between EB and SS (Cohen \u03ba=94.5%). By contrast, mPCR (Idylla MSI Test) showed lower sensitivity in evaluating MSI status (91.3% vs. 97.3%), while maintaining maximal specificity (100.0%). These results suggest a role of IHC as a screening method for MMR status in EB and the use of mPCR as a confirmatory test. Although Laur\u00e9n\/WHO classifications were not able to discriminate GC cases with MSI, we identified specific histopathologic features that are significantly associated with MMR\/MSI status in GC, despite the morphologic heterogeneity of GC cases harboring this molecular phenotype. In SS, these features included the presence of mucinous and\/or solid components (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.034 and &lt;0.001) and the presence of neutrophil-rich stroma, distant from tumor ulceration\/perforation (<jats:italic toggle=\"yes\">P<\/jats:italic>&lt;0.001). In EB, both solid areas and extracellular mucin lakes were also discriminating features for the identification of MSI-high cases (<jats:italic toggle=\"yes\">P<\/jats:italic>=0.002 and 0.045).<\/jats:p>","DOI":"10.1097\/pas.0000000000002085","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T10:14:08Z","timestamp":1687860848000},"page":"990-1000","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Role of Endoscopic Biopsies and Morphologic Features in Predicting Microsatellite Instability Status in Gastric Cancer"],"prefix":"10.1097","volume":"47","author":[{"given":"Jo\u00e3o R.","family":"Silva","sequence":"first","affiliation":[{"name":"Faculty of Medicine of the University of Porto (FMUP)"}]},{"given":"Lu\u00eds","family":"Mascarenhas-Lemos","sequence":"additional","affiliation":[{"name":"Pathology"},{"name":"Faculty of Medicine, Catholic University of Portugal"},{"name":"NOVA Medical School, Universidade NOVA Lisbon"}]},{"given":"Catarina","family":"Neto do Nascimento","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Beatriz Angelo Hospital (HBA), Loures, Portugal"}]},{"given":"Diogo","family":"Sousa Marques","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of the University of Porto (FMUP)"}]},{"given":"Xiaogang","family":"Wen","sequence":"additional","affiliation":[{"name":"i3S (Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) and Ipatimup (Institute of Molecular Pathology and Immunology of the University of Porto)"},{"name":"Department of Pathology, Centro Hospitalar Universit\u00e1rio do Porto (CHUP)"}]},{"given":"L\u00eddia","family":"Pinho","sequence":"additional","affiliation":[{"name":"i3S (Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) and Ipatimup (Institute of Molecular Pathology and Immunology of the University of Porto)"}]},{"given":"Rui","family":"Maio","sequence":"additional","affiliation":[{"name":"Surgery"},{"name":"NOVA Medical School, Universidade NOVA Lisbon"}]},{"given":"Patr\u00edcia","family":"Pontes","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Center of S\u00e3o Jo\u00e3o (CHUSJ)"}]},{"given":"Lu\u00eds","family":"Cirnes","sequence":"additional","affiliation":[{"name":"i3S (Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) and Ipatimup (Institute of Molecular Pathology and Immunology of the University of Porto)"}]},{"given":"Mar\u00edlia","family":"Cravo","sequence":"additional","affiliation":[{"name":"Gastroenterology, Hospital da Luz Lisbon"},{"name":"Faculty of Medicine, University of Lisbon (FMUL), Lisbon"}]},{"given":"F\u00e1tima","family":"Carneiro","sequence":"additional","affiliation":[{"name":"i3S (Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) and Ipatimup (Institute of Molecular Pathology and Immunology of the University of Porto)"},{"name":"Department of Pathology, University Hospital Center of S\u00e3o Jo\u00e3o (CHUSJ)"},{"name":"Department of Pathology, FMUP, Porto"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3377-0530","authenticated-orcid":false,"given":"Irene","family":"Gullo","sequence":"additional","affiliation":[{"name":"i3S (Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade) and Ipatimup (Institute of Molecular Pathology and Immunology of the University of Porto)"},{"name":"Department of Pathology, University Hospital Center of S\u00e3o Jo\u00e3o (CHUSJ)"},{"name":"Department of Pathology, FMUP, Porto"}]}],"member":"276","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"R1-20250608","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R2-20250608","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000473881","article-title":"Heterogeneity in gastric cancer: from pure morphology to molecular classifications","volume":"85","author":"Gullo","year":"2018","journal-title":"Pathobiology"},{"key":"R3-20250608","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. 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