Immunohistochemical Algorithm of Neumann et al for Determining the Risk of Distant Metastases in a Patient with a Cancer Arising in the Right Colon

Description

Neumann et al used 3 immunohistochemical tests to stratify patients with a right-sided colon cancer for the risk of distant metastases. A patient at increased risk for distant metastases may benefit from more aggressive management. The authors are from Ludwig-Maximilians Universitat in Munich.

Patient selection: right-sided colon cancer

Outcome: distant metastases

Testing:

(1) MLH1 nuclear expression (positive iindicates preserved expression, negative indicates loss)

(2) CD133 (high if there is strong apical expression)

(3) beta-catenin (high if there is nuclear staining)

MLH1 Staining	CD133	beta-Catenin	Risk of Distant Metastases
negative	NA	NA	low (5%)
positive	low	NA	intermediate (50%)
positive	high	low	intermediate (60%)
positive	high	high	high (94%)

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Immunohistochemical Algorithm of Neumann et al for Determining the Risk of Distant Metastases in a Patient with a Cancer Arising in the Right Colon

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