Abstract

Research on hMLH1 and hMSH2 mutations tend to focus on Lynch syndrome (LS) and LS-like colorectal cancer (CRC). No studies to date have assessed the role of hMLH1 and hMSH2 genes in mass sporadic CRC (without preselection by MSI or early age of onset). We aimed to identify novel hMLH1 and hMSH2 DNA variants, to determine the mutation frequencies and sites in both sporadic and LS CRC and their relationships with clinicopathological characteristics of CRC in Northeast of China. 452 sporadic and 21 LS CRC patients were screened for germline and somatic mutations in hMLH1 and hMSH2 genes with PCR–SSCP sequencing. We identified 11 hMLH1 and seven hMSH2 DNA variants in our study cohort. Six of them were novel: four in hMLH1 gene (IVS8-16 A>T, c.644 GAT>GTT, c.1529 CAG>CGG and c.1831 ATT>TTT) and two in hMSH2 gene (−39 C>T, insertion AACAACA at c.1127 and deletion AAG at c.1129). In sporadic CRC, germline and somatic mutation frequencies of hMLH1/hMSH2 gene were 15.59% and 17.54%, respectively (p = 0.52). Germline mutations present in hMLH1 and hMSH2 genes were 5.28% and 10.78%, respectively (p<0.01). Somatic mutations in hMLH1 and hMSH2 genes were 6.73% and 11.70%, respectively (p = 0.02). In LS CRC, both germline and somatic mutation frequencies of hMLH1/hMSH2 gene were 28.57%. The most prevalent germline mutation site in hMSH2 gene was c.1168 CTT>TTT (3.90%), a polymorphism. Somatic mutation frequency of hMLH1/hMSH2 gene was significantly different in proximal, distal colon and rectal cancer (p = 0.03). Our findings elucidate the mutation spectrum and frequency of hMLH1 and hMSH2 genes in sporadic and LS CRC, and their relationships with clinicopathological characteristics of CRC.

Highlights

  • Colorectal cancer (CRC) is one of the most common malignancies globally, and ranks the fifth of all cancers in China

  • One of the genetic pathways in the development of CRC is the failure of DNA mismatch repair (MMR) system [2], which contributes to the maintenance of genomic stability by recognizing and removing insertion/deletion mutations that occur during DNA replication [3]

  • We identified 11 DNA variants in hMLH1 gene

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Summary

Introduction

Colorectal cancer (CRC) is one of the most common malignancies globally, and ranks the fifth of all cancers in China. 30 small-sample size (n = 5–61, except for one of 315 patients) studies have been published that screened germline mutations in hMLH1 and hMSH2 genes in sporadic CRC. In our analysis of these 30 studies, MSI or early-age onset (under the age of 40, 45, 50 or 55 years) was used to preselect patients for hMLH1 and hMSH2 gene mutations in sporadic CRC. No study aimed to detect mutation frequencies of hMLH1 and hMSH2 genes in mass sporadic CRC without MSI or age preselection. In China, four studies (n = 26–58) screened germline or somatic mutations of hMLH1 and hMSH2 genes in sporadic CRC with preselection by MSI [7,8,9,10].

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