Microsatellite instability in prostate cancer: a current diagnostic approach

Daniel G. Acosta-Ramírez, Departamento de Molecular y Genómica, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
Ana K. Flores-Islas, Doctorado Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México
Aurelio Gómez-Landero, Hospital de Ginecoobstetricia, Unidad Médica de Alta Especialidad, Centro Médico Nacional del Occidente, Guadalajara, Jalisco, Mexico
Erick Sierra-Díaz, División de Epidemiología, UMAE Hospital de Especialidades Centro Médico Nacional de Occidente, Guadalajara, Jalisco, Mexico
José M. Moreno-Ortíz, Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
Ana L. Pereira-Suárez, Departamento de Molecular y Genómica, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara; Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Guadalajara, Jalisco, Mexico
Adrián Ramírez-de-Arellano, Departamento de Molecular y Genómica, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico

Microsatellite instability (MSI), a hallmark of DNA mismatch repair (MMR) deficiency, has become an important biomarker in cancer biology. It has been extensively studied in colorectal and endometrial cancers, MSI is less common studied, but clinically impactful in prostate cancer. Tumors with high MSI in prostate cancer often demonstrated aggressive behavior, elevated the burden in tumor mutation, and potential responsiveness to immunotherapy. Accurate MSI detection is crucial for advancing in a more personalized medicine, which in turn will guide the therapeutic decisions, and improving patient outcomes. This article makes a review of diagnostic methods for MSI in prostate cancer, including immunohistochemistry (IHC), polymerase chain reaction (PCR), and next-generation sequencing (NGS). Each one of these methods offers unique advantages, with IHC and PCR being cost-effective and suitable for routine diagnostics, while NGS provides comprehensive molecular insights at a higher cost. The integration of MSI testing into clinical practice will advance the shift towards a more precise medicine, offering hope for tailored therapies and improved prognoses in prostate cancer management.

Keywords: Microsatellite instability. Prostate cancer. DNA mismatch repair. Immunohistochemistry. Polymerase chain reaction. Next-generation sequencing.