Microsatellite instability in sporadic colon carcinomas has no independent prognostic value in a Belgian study population.

Pathological stage is currently the most important determinant of colorectal cancer prognosis. Hence, identification of additional prognostic markers is warranted. This study aimed to analyse the prognostic relevance of microsatellite instability (MSI) in 241 colon and 90 rectal tumours, using a mononucleotide loci multiplex PCR assay and immunohistochemistry. Thirty (12.4%) colon tumours and one rectal tumour showed MSI. Although MSI was associated with proximal location and poor differentiation, no survival benefit was observed. The prognostic value of stage and differentiation was confirmed in this study. Analysis by stage revealed a longer overall (stage II/III) and disease free survival (stage II) for patients with well differentiated tumours. In addition, age and distal localisation were related to longer overall survival in stage II tumours. In conclusion, our findings show an association of MSI in sporadic colon tumours and certain clinical features; however, they do not suggest a survival benefit for MSI tumours.

Budesonide in collagenous colitis: a double-blind placebo-controlled trial with histologic follow-up.

BACKGROUND & AIMS: Collagenous colitis (CC) is a well-described entity causing chronic diarrhea and characteristic histologic findings. Several treatment options have been suggested, but no controlled data are available. We conducted a placebo-controlled trial to show the clinical and histologic effects of budesonide in CC. METHODS: Twenty-eight patients were randomly assigned to receive placebo (n = 14) or budesonide 9 mg daily (n = 14) for 8 weeks. Patients were evaluated clinically, and blinded biopsy specimens were analyzed from fixed locations at weeks 0 and 8. Clinical response was defined as a decrease of at least 50% in the disease activity score (number of bowel movements in the last 7 days). At week 8, nonresponders received open-label budesonide for the next 8-week period; responders discontinued treatment and were followed up. RESULTS: Three patients discontinued the study prematurely. Intention-to-treat analysis showed clinical response in 8 of 14 patients in the budesonide group compared with 3 of 14 responders for placebo (P = 0.05) after 8 weeks of blinded therapy, together with improved stool consistency. Histologically, there was no change in the mean thickness of the collagen band but a significant decrease of the lamina propria infiltrate in the budesonide group (P < 0.001). CONCLUSIONS: Budesonide is efficacious in inducing short-term clinical response in CC with significant reduction of the histologic infiltrate in the lamina propria.