{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:56:37Z","timestamp":1788976597489,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2021,6,30]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Analysis of microsatellite instability (MSI) is strongly recommended in endometrial cancer (EC) and colorectal cancer to screen for Lynch syndrome, to predict prognosis and to determine optimal treatment and follow-up. In a large monoinstitutional series of ECs, we evaluated the reliability and accuracy of Idylla assay, a rapid, fully automated system to detect MSI, and we compared its performance with two routine reference methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated MSI status in 174 formalin-fixed, paraffin-embedded EC tissue samples using immunohistochemistry (IHC) for mismatch repair (MMR) proteins and Idylla assay. Samples with discordant or equivocal results were analysed with a third technique, the Promega MSI kit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Idylla MSI assay and IHC were highly concordant (overall agreement: 154\/170=90.59%, 95% CI 85.26% to 94.12%). However, in four samples, MMR-IHC staining was equivocal; moreover, 16 cases showed discordant results, that is, MMR deficient using IHC and microsatellite stable using Idylla. These 20 samples were reanalysed using the MSI-Promega kit, which showed the same results of Idylla assay in 18\/20 cases (overall agreement: 90%, 95% CI 69.90% to 97.21%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest that IHC is an efficient method to determine MMR status in ECs. However, the Idylla MSI assay is a rapid and reliable tool to define MSI status, and it could represent a valuable alternative to conventional MSI-PCR methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jclinpath-2021-207723","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T13:20:24Z","timestamp":1627305624000},"page":"29-33","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Microsatellite instability evaluation: which test to use for endometrial cancer?"],"prefix":"10.1136","volume":"76","author":[{"given":"Paola","family":"Rafaniello-Raviele","sequence":"first","affiliation":[{"name":"Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9191-8228","authenticated-orcid":false,"given":"Ilaria","family":"Betella","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Rappa","sequence":"additional","affiliation":[{"name":"Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Vacirca","sequence":"additional","affiliation":[{"name":"Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Tolva","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliana","family":"Guerrieri-Gonzaga","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Bertario","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-4804","authenticated-orcid":false,"given":"Massimo","family":"Barberis","sequence":"additional","affiliation":[{"name":"Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Bonanni","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4216-230X","authenticated-orcid":false,"given":"Monica","family":"Marabelli","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Lombardy, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"2025120521434950000_76.1.29.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12935-019-1091-8"},{"key":"2025120521434950000_76.1.29.2","doi-asserted-by":"publisher","DOI":"10.1038\/cr.2007.115"},{"key":"2025120521434950000_76.1.29.3","unstructured":"World Health Organization . GLOBOCAN, 2020. Available: https:\/\/gco.iarc.fr\/ [Accessed 08 Jan 2021]."},{"key":"2025120521434950000_76.1.29.4","article-title":"Landscape of microsatellite instability across 39 cancer types","volume":"2017","author":"Bonneville","year":"2017","journal-title":"JCO Precis Oncol"},{"key":"2025120521434950000_76.1.29.5","unstructured":"Idos G , Valle L . Lynch Syndrome. In: Adam MP , Ardinger HH , Pagon RA , eds. GeneReviews\u00ae. Seattle (WA): University of Washington, Seattle, 2004: 1993\u20132021. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK1211\/"},{"key":"2025120521434950000_76.1.29.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3878"},{"key":"2025120521434950000_76.1.29.7","article-title":"Universal testing for MSI\/MMR status in colorectal and endometrial cancers to identify Lynch syndrome cases: state of the art in Italy and consensus recommendations from the Italian association for the study of familial gastrointestinal tumors (A.I.F.E.G.)","author":"Tibiletti","year":"2021","journal-title":"Eur J Cancer Prev"},{"key":"2025120521434950000_76.1.29.8","doi-asserted-by":"publisher","DOI":"10.1038\/nature12113"},{"key":"2025120521434950000_76.1.29.9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30496"},{"key":"2025120521434950000_76.1.29.10","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy058"},{"key":"2025120521434950000_76.1.29.11","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-1678"},{"key":"2025120521434950000_76.1.29.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2018.06.001"},{"key":"2025120521434950000_76.1.29.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500596"},{"key":"2025120521434950000_76.1.29.14","doi-asserted-by":"publisher","DOI":"10.1126\/science.aan6733"},{"key":"2025120521434950000_76.1.29.15","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz116"},{"key":"2025120521434950000_76.1.29.16","first-page":"5248","article-title":"A national cancer Institute workshop on microsatellite instability for cancer detection and familial predisposition: development of international criteria for the determination of microsatellite instability in colorectal cancer","volume":"58","author":"Boland","year":"1998","journal-title":"Cancer Res"},{"key":"2025120521434950000_76.1.29.17","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djh034"},{"key":"2025120521434950000_76.1.29.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2020.06.002"},{"key":"2025120521434950000_76.1.29.19","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-206581"},{"key":"2025120521434950000_76.1.29.20","first-page":"104","article-title":"Immunohistochemical evaluation of mismatch repair proteins in colorectal carcinoma: the AIFEG\/GIPAD proposal","volume":"108","author":"Remo","year":"2016","journal-title":"Pathologica"},{"key":"2025120521434950000_76.1.29.21","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/annonc\/mdw542","article-title":"Practical guidance for mismatch repair-deficiency testing in endometrial cancer","volume":"28","author":"Stelloo","year":"2017","journal-title":"Ann Oncol"},{"key":"2025120521434950000_76.1.29.22","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9896(2000)9999:9999<::AID-PATH701>3.0.CO;2-2"},{"key":"2025120521434950000_76.1.29.23","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e31818fa2db"},{"key":"2025120521434950000_76.1.29.24","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28933"},{"key":"2025120521434950000_76.1.29.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmoldx.2019.12.002"},{"key":"2025120521434950000_76.1.29.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.yexmp.2020.104519"},{"key":"2025120521434950000_76.1.29.27","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-020-02962-x"},{"key":"2025120521434950000_76.1.29.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2019.05.006"},{"key":"2025120521434950000_76.1.29.29","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2019-205935"},{"key":"2025120521434950000_76.1.29.30","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2020-207033"},{"key":"2025120521434950000_76.1.29.31","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-73421-5"},{"key":"2025120521434950000_76.1.29.32","doi-asserted-by":"crossref","DOI":"10.3390\/cancers13061268","article-title":"Managing difficulties of microsatellite instability testing in endometrial Cancer-Limitations and advantages of four different PCR-based approaches","volume":"13","author":"Siemanowski","year":"2021","journal-title":"Cancers"},{"key":"2025120521434950000_76.1.29.33","doi-asserted-by":"crossref","DOI":"10.1007\/s00428-021-03082-w","article-title":"Detection of microsatellite instability with Idylla MSI assay in colorectal and endometrial cancer","author":"Ukkola","year":"2021","journal-title":"Virchows Arch"},{"key":"2025120521434950000_76.1.29.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmoldx.2016.07.008"},{"key":"2025120521434950000_76.1.29.35","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0179-3"}],"container-title":["Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jclinpath-2021-207723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:44:00Z","timestamp":1764999840000},"score":1,"resource":{"primary":{"URL":"https:\/\/jcp.bmj.com\/lookup\/doi\/10.1136\/jclinpath-2021-207723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,26]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12,24]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/jclinpath-2021-207723"],"URL":"https:\/\/doi.org\/10.1136\/jclinpath-2021-207723","relation":{},"ISSN":["0021-9746","1472-4146"],"issn-type":[{"value":"0021-9746","type":"print"},{"value":"1472-4146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,26]]}}}