Colorectal Cancer: Molecular Diagnostics

Practical molecular pathology of colon cancer is the focus of this presentation. Topics include MSI testing by PCR, IHC and germline testing and how to distinguish sporadic MSI-high colon cancer from inherited Lynch syndrome MSI-high cancers. The therapeutic, familial, syndromic, and prognostic reasons for why this MSI-high differential is critical are fully explored. KRAS and BRAF testing and their significance to EGFR pathway chemotherapy are reviewed. Helpful information on microdissection in molecular testing is provided.

Lecture Presenter
Mary Bronner, MD
Mary Bronner, MD
Carl R. Kjeldsberg Presidential Endowed Chair Professor of Pathology, University of Utah School of Medicine
Division Chief, Anatomic Pathology and Solid Tumor Molecular Oncology, ARUP Laboratories

Dr. Mary Bronner is the division chief of anatomic pathology and oncology at ARUP Laboratories and the Carl R. Kjeldsberg presidential endowed chair professor of pathology at the University of Utah. Dr. Bronner received her medical degree from the University of Pennsylvania, where she also completed a residency. She is on the editorial board of both Human Pathology and Modern Pathology journals. She has received the Arthur Purdy Stout Prize, has served as president of the GI Pathology Society and as a council member of the United States and Canadian Academy of Pathology. Dr. Bronner specializes in gastrointestinal, hepatic, and pancreaticobiliary pathology, and molecular oncology. Her research interests include basic, translational, and clinical GI as well as hepatic and pancreaticobiliary pathology.

Objectives

After this presentation, participants will be able to:

Understand the biology of, the universal testing requirement for, and the testing approaches to microsatellite instability (MSI) in colon cancer and how to differentiate sporadic from Lynch syndrome MSI-high colorectal adenocarcinomas
Understand why KRAS mutation testing is mandatory for metastatic colorectal cancer
Understand why BRAF mutation testing is mandatory in colorectal cancer
Understand that differentiating hyperplastic polyps from sessile serrated lesions relies on clinicopathologic criteria and that molecular testing has no role
Learn the ideal approach to cancer microdissection for molecular testing