Genetic Nonpolyposis Colorectal Cancer Prediction Using mRNA MSH2 Quantitative Analysis and Its Association with Immutable Factors

Abstract

This chapter aimed to compute suitable MSH2 gene expression for appropriate cut-off and certify the associations from the risk factors. A dominantly inherited syndrome of colorectal cancer (CRC), hereditary non-polyposis colon cancer carries a higher risk for the younger population. Previous research links the Amsterdam and Bethesda criteria, as well as DNA sequence polymorphism, to its vulnerability. Nevertheless, those are not applicable.

The cross-sectional study observed 71 respondents from May 2018 to December 2019 in determining the CRC hereditary status through MSH2 mRNA expression using reverse transcription-polymerase chain reaction and the disease’s risk factors. Data were analyzed through Chi-Square, Fischer exact, t-test, Mann- Whitney, and multiple logistics.

 It is revealed that MSH2 levels in tissue and blood within the CRC group differ significantly, but there are no significant differences across the groups. The hereditary CRC cut-off is 11059 fc through the blood gene expression fifth percentile, separating the 40 CRC responses into 32.5% with hereditary CRC.  CRC higher prevalence in the male gender is the result of female protectiveness from the disease. The sex hormone of estradiol and progesterone acts as protective mechanism for CRC development in the body. The hormonal clinical trial in 2019 observe that introduction of estradiol and progesterone combination treatment provide increased apoptosis of tumor cells (P < 0.05) while lowering tumor cell proliferations (P < 0.01). Significant risk factors include age, family history, and staging. Nonetheless, after multivariate control, age is just a confounder. Further, the study develops a probability equation with area under the curve 82.2%.

The heredity of CRC patients is significantly influenced by a wide range of factors. But while age and other variables are confounding factors, staging and family history are very key factors. The study also established a definite cut-off point for heredity CRC based on mRNA MSH2 expression, 11059 fc. These findings shall act as concrete foundations on further risk factors and/or genetical CRC future studies.