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Microsatellite Instability (MSI) IHC Test

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Microsatellite Instability (MSI) IHC Test

Short Name: MSI IHC

Also known as: MSI IHC Test, Microsatellite Instability Immunohistochemistry, MSI by IHC

Microsatellite Instability (MSI) IHC Test test available at DNA Labs India for ₹16,000. Uses Immunohistochemistry (IHC) for MMR proteins (MLH1, PMS2, MSH2, MSH6) on FFPE Tissue Block samples. Results in Reports are typically available within 10 days after the laboratory receives the FFPE tissue block.. Free home collection in 300+ cities across India.

Immunohistochemistry (IHC)Adult🏠 Home Collection

✍️ Written By

🩺 Medically Reviewed By

Dr Pasupathy Arumugam

Dr Pasupathy Arumugam

Consultant Pathologist · Reg: 21521

Last reviewed: September 7, 2026

Overview

The primary purpose of the MSI IHC test is to evaluate the functional status of the DNA mismatch repair system in tumor tissue. It helps in: 1) Diagnosing MSI in cancers such as colorectal, endometrial, and ovarian cancer. 2) Identifying patients who are candidates for immunotherapy (e.g., PD-1 inhibitors) as MSI-high tumors respond well to these treatments. 3) Screening for Lynch syndrome, an inherited condition that increases the risk of multiple cancers. 4) Guiding prognosis and treatment planning in oncology.

Test Code
6303
CPT Code
88342
ICD Code
Z12.11
Price
₹16,000
Sample Type
FFPE Tissue Block
Result Time
Reports are typically available within 10 days after the laboratory receives the FFPE tissue block.
Fasting Required
No
Method
Immunohistochemistry (IHC) for MMR proteins (MLH1, PMS2, MSH2, MSH6)
Step 1

Sample Collection

No special preparation is required. The test is performed on a tissue sample obtained from a biopsy or surgery. Inform your doctor about any medications you are taking.

Method: Biopsy or surgical resection specimen

Step 2

Laboratory Analysis

The tissue sample is collected during a biopsy or surgical procedure. The sample is then fixed in formalin and embedded in paraffin (FFPE block) for testing.

Step 3

Report Delivery

No specific aftercare is needed. You can resume normal activities immediately. The sample is sent to the laboratory for analysis.

Timeline: Reports are typically available within 10 days after the laboratory receives the FFPE tissue block.

Patient Instructions

1
Before the Test:No special preparation is needed. Ensure you have discussed the test with your doctor and provided a complete medical history.
2
During the Test:The test is performed on a tissue sample already collected during biopsy or surgery. No additional procedure is needed for the test itself.
3
After the Test:You will receive your report within 10 days. Discuss the results with your doctor to understand the implications for your treatment.

About This Test

Who Should Get This Test

The primary purpose of the MSI IHC test is to evaluate the functional status of the DNA mismatch repair system in tumor tissue. It helps in: 1) Diagnosing MSI in cancers such as colorectal, endometrial, and ovarian cancer. 2) Identifying patients who are candidates for immunotherapy (e.g., PD-1 inhibitors) as MSI-high tumors respond well to these treatments. 3) Screening for Lynch syndrome, an inherited condition that increases the risk of multiple cancers. 4) Guiding prognosis and treatment planning in oncology.

How to Prepare

  • Ensure the tissue sample is properly fixed in 10% neutral buffered formalin
  • The FFPE block should be labeled with patient identification and specimen source
  • Transport the sample at room temperature to the laboratory
  • Avoid freezing the tissue block as it may damage the sample

Doctor's Notes

Reviewed by — MBBS, MD (Pathology) · Reg. No. 21521

"MSI testing is crucial for identifying patients who may benefit from immunotherapy and for screening Lynch syndrome. Early detection improves outcomes."

Last medically reviewed: September 7, 2026

Test Parameters & Specifications

Sample TypeFFPE Tissue Block
Sample Volume1 tissue block (paraffin-embedded)
ContainerFFPE block in a sealed container
Collection MethodBiopsy or surgical resection specimen

Sample Stability

FFPE blocks are stable for years at room temperature
Slides prepared from FFPE blocks should be stored in a cool, dry place
Sample Rejection Criteria:
  • Inadequate tissue sample (less than 5 mm in diameter)
  • Poorly fixed or autolyzed tissue
  • Non-FFPE samples (e.g., frozen tissue) not accepted for this test
  • Unlabeled or mislabeled specimens

Understanding Your Results

The MSI IHC test results are interpreted based on the nuclear staining pattern of the four MMR proteins. Normal expression (positive staining) indicates intact MMR function, while loss of expression (negative staining) suggests MMR deficiency.
📊

Loss of MLH1 and PMS2

MSI-High; may benefit from immunotherapy; consider Lynch syndrome screening if MLH1 methylation is absent

📊

Loss of MSH2 and MSH6

MSI-High; refer for genetic counseling and germline testing

📊

Isolated loss of MSH6

MSI-High; genetic counseling recommended

📊

Isolated loss of PMS2

MSI-High; genetic counseling recommended

📊

All four proteins present (normal)

No MSI; immunotherapy may be less effective; consider other biomarkers

⚠️ When to Consult a Doctor:

Consult your oncologist or gastroenterologist if you experience symptoms such as unexplained weight loss, blood in stool, abdominal pain, or changes in bowel habits, especially if you have a family history of colorectal or endometrial cancer. Early testing can lead to timely intervention.

Limitations

  • ⚠IHC may miss rare MMR mutations that do not affect protein expression
  • ⚠Interpretation requires expertise; equivocal results may need reflex molecular testing (e.g., PCR)
  • ⚠Not a substitute for genetic counseling or germline testing for Lynch syndrome

Risks & Considerations

  • ●No direct risks from the test itself as it is performed on an existing tissue sample
  • ●Risks associated with the biopsy procedure (e.g., bleeding, infection) are separate and should be discussed with your doctor

Interfering Factors

  • ●Poor tissue fixation or processing may affect antigenicity
  • ●Decalcification of bone specimens can degrade proteins
  • ●Necrotic or inadequate tissue samples may yield false results
  • ●Prior chemotherapy or radiation may alter protein expression

Compare With Similar Tests

TestMicrosatellite Instability (MSI) IHC TestMSI IHCMSI PCRNext-Generation Sequencing (NGS)
ComparisonMicrosatellite Instability (MSI) IHC Test

Frequently Asked Questions

What is the cost of the MSI IHC test at DNA Labs India?
The cost of the Microsatellite Instability (MSI) IHC test at DNA Labs India is INR 16000. This includes home sample collection and report delivery.
What sample is required for the MSI IHC test?
The test requires an FFPE (formalin-fixed, paraffin-embedded) tissue block obtained from a biopsy or surgical resection.
Is fasting required before the MSI IHC test?
No, fasting is not required for this test as it is performed on a tissue sample, not blood.
How long does it take to get the MSI IHC test results?
The turnaround time is 10 days from the receipt of the tissue block at the laboratory.
What does MSI IHC test detect?
It detects the expression of four mismatch repair proteins (MLH1, PMS2, MSH2, MSH6) in tumor tissue. Loss of expression indicates microsatellite instability.
Is the MSI IHC test covered by insurance?
Coverage varies by insurance provider. It is advisable to check with your insurance company. DNA Labs India offers the test at a discounted price of INR 16000.
Can the MSI IHC test be done at home?
Yes, DNA Labs India offers free home sample collection for this test. A trained phlebotomist will collect the tissue block from your location.
What is the difference between MSI and MSS?
MSI (Microsatellite Instability) refers to changes in microsatellite sequences due to MMR deficiency, while MSS (Microsatellite Stable) means no such changes. MSI-high tumors respond better to immunotherapy.
Who should get the MSI IHC test?
Patients with colorectal, endometrial, or ovarian cancer, especially those diagnosed at a young age or with a family history of Lynch syndrome, should consider this test.
What is Lynch syndrome?
Lynch syndrome is an inherited condition caused by mutations in MMR genes, leading to a high risk of colorectal, endometrial, and other cancers. MSI IHC is a screening tool for this syndrome.
Are there any risks associated with the MSI IHC test?
No, the test itself poses no risks as it is performed on an existing tissue sample. Risks are associated with the biopsy procedure, which should be discussed with your doctor.
How accurate is the MSI IHC test?
The test is highly accurate, but in rare cases, it may miss mutations that do not affect protein expression. Confirmatory molecular testing may be recommended if results are equivocal.
Worried about the process? Our certified phlebotomists collect thousands of samples every month across India. The process takes under 5 minutes and is virtually painless. Questions? Message us on WhatsApp — we're here 7 days a week.

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