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MBBS, DCP, DNB Pathology
Pathology · Last reviewed: June 2026
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IHC - Microsatellite Instability for Colorectal Carcinoma MLH-1
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About this test
The IHC – Microsatellite Instability (MSI) for Colorectal Carcinoma MLH1 test is a specialized immunohistochemistry (IHC) diagnostic test used to detect MLH1 protein expression in colorectal cancer tissue samples. MLH1 is one of the key DNA mismatch repair (MMR) proteins responsible for correcting DNA replication errors. Loss of MLH1 expression may indicate microsatellite instability (MSI), a condition linked to colorectal cancer and hereditary cancer syndromes such as Lynch syndrome.
This test is an essential part of colorectal cancer evaluation because it helps determine whether tumor cells have defective DNA repair mechanisms. Tumors with MSI often behave differently, respond better to certain treatments such as immunotherapy, and may indicate inherited cancer risk.
The MLH1 IHC test is usually performed along with other mismatch repair markers such as MSH2, MSH6, and PMS2 for comprehensive microsatellite instability screening.
Benefits of the Test
The MLH1 MSI test offers several important benefits:
- Detects loss of MLH1 protein expression
- Identifies microsatellite instability in colorectal tumors
- Helps screen for Lynch syndrome
- Supports accurate colorectal cancer classification
- Guides treatment decisions, including immunotherapy eligibility
- Helps assess hereditary cancer risk
This test is highly valuable for both diagnosis and long-term patient management.
Why Doctors Recommend This Test
Doctors recommend the MLH1 IHC test when colorectal cancer is diagnosed or strongly suspected. It is commonly advised for:
- Newly diagnosed colorectal carcinoma patients
- Early-onset colorectal cancer cases
- Patients with family history of colorectal or related cancers
- Suspected Lynch syndrome evaluation
- Cases requiring advanced tumor molecular profiling
The results help oncologists decide on targeted treatment options and recommend genetic counseling if hereditary cancer risk is suspected.
Preparation Before Test
No special preparation is required from the patient. The test is performed on previously collected tissue biopsy or surgical tumor specimens.
Normal Reporting Time
The normal turnaround time for the MLH1 IHC test is 3 to 5 working days, depending on laboratory processing and tissue complexity.
Who Should Take This Test
This test is recommended for:
- Patients diagnosed with colorectal carcinoma
- Individuals with family history of Lynch syndrome
- Patients with early-age colorectal cancer
- Cases needing microsatellite instability screening
- Oncology patients requiring treatment selection guidance
The IHC MLH1 test is a vital diagnostic tool in colorectal cancer care. It helps identify microsatellite instability, assess inherited cancer risk, and guide modern precision treatment strategies. Early detection of MLH1 loss improves patient outcomes and supports preventive family screening.
Test FAQs
What is the MLH1 IHC test?
Why is MLH1 important?
What does loss of MLH1 mean?
Is this a blood test?
What cancers use this marker?
Is preparation required?
How long does reporting take?
Is MLH1 tested alone?
Who interprets the results?
Can this test guide treatment?
IHC - Microsatellite Instability for Colorectal Carcinoma MLH-1
Rs. 2400
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