Microsatellite instability
| No of detectable
 markers:
 | 7 | 
| Lab method: | Fragment analysis | 
| Specimen requirements: | Paraffin-embedded, formalin-fixed block of tumor tissue from colon and normal tissue 
The best material of tumor tissue is pre-treatment biopsy.The best material of normal tissue is surgical resection or 2-4 ml of blood (with anticoagulant EDTA).Storage and transport temperature for paraffin-embedded, formalin-fixed tissue blocks is 20-25°C.Testing results cannot be guaranteed when DNA quality is poor or DNA is too fragmented due to previous tissue fixation process. | 
 
Indications for genetic testing:
- 
- Testing of individuals with colorectal or other Lynch-associated cancers to estimate the probability of mutations in mismatch repair genes
- Determination of disease prognosis
- Genetic counseling
 
Microsatellite instability (MSI) is the mutational signature found in colorectal cancers that evolve as a result of inactivation of the DNA mismatch repair system. Defects in the genes involved in mismatch repair lead to an accumulation of somatic mutations in a cell, which may result in the cell becoming malignant. Germline mutations in mismatch repair genes are associated with developing hereditary non-polyposis colon cancer. Approximately 90% of colon cancers from families meeting Amsterdam criteria have MSI.