Occurrence Of Microsatellite Instability Research Articles

Association of Functional Polymorphisms in MSH3 and IL-6 Pathway Genes with Different Types of Microsatellite Instability in Sporadic Colorectal Cancer.

Microsatellite instability (MSI) has been recognized as an important factor in colorectal cancer (CRC). It arises due to deficient mismatch repair (MMR), mostly attributed to MLH1 and MSH2 loss of function leading to a global MMR defect affecting mononucleotide and longer microsatellite loci. Recently, microsatellite instability at tetranucleotide loci, independent of the global MMR defect context, has been suggested to represent a distinct entity with possibly different consequences for tumorigenesis. It arises as a result of an isolated MSH3 loss of function due to its translocation from the nucleus to the cytoplasm under the influence of interleukin-6 (IL-6). In this study the influence of MSH3 and IL-6 signaling pathway polymorphisms (MSH3 exon 1, MSH3+3133A/G, IL-6-174G/C, IL-6R+48892A/C, and gp130+148G/C) on the occurrence of different types of microsatellite instability in sporadic CRC was examined by PCR-RFLP and real-time PCR SNP analyses. A significant difference in distribution of gp130+148G/C genotypes (p = 0.037) and alleles (p = 0.031) was observed in CRC patients with the C allele being less common in tumors with di- and tetranucleotide instability (isolated MSH3 loss of function) compared to tumors without microsatellite instability. A functional polymorphism in gp130 might modulate the IL-6 signaling pathway, directing it toward the occurrence of microsatellite instability corresponding to the IL-6-mediated MSH3 loss of function.

Abstract 4096: Comparative molecular profiling of sporadic and Lynch syndrome MSI tumors: Unraveling insights for vaccine design

Abstract Lynch Syndrome (LS) is a hereditary syndrome that predisposes carriers to colorectal cancer (CRC). The hallmark of LS is microsatellite instability (MSI), resulting from a defective DNA mismatch repair (MMR) system. MSI cases have hyper-elevated frameshift mutation rates including “shared” hotspot mutations recurrently across patients. Frameshift mutations can generate neopeptides that activate the immune system. These open the door for preventive vaccines. However, preventive vaccines work best with neopeptides that happen early during tumorigenesis. Here we present 83 newly sequenced adenomas and carcinomas from Lynch syndrome carriers and combine them with previously published 68 Lynch cases and 133 Sporadic cases, thus generating the largest currently available colorectal neoplasia MSI cohort. We leveraged this large cohort to analyze the molecular landscape of adenomas vs carcinoma tumors and Lynch vs sporadic tumors. Employing our recently developed MSIDetect tool on our WGS samples, we identified microsatellite instability in 75% of adenomas, which is higher than previously reported. We found that about 30% of normal adjacent tissues showed MSI, suggesting early mismatch repair defects. This early MSI occurrence supports the potential effectiveness of preventive vaccines. We observed comparable levels of SNVs, microsatellite Indels, and single base signature activity among Lynch adenomas and carcinomas, as well as sporadic carcinomas while adjusting for variations in coverage across different datasets. Moreover, using RNA sequencing data and PCA analysis we found that adenoma and carcinoma cluster together. This large cohort enabled us to identify (as fast as we know for the first time) MS-indels that tend to have a second MS-indel in the same locus. The high similarities observed between Lynch and sporadic tumors allow for their combination in one vaccine. Using the combined MSI cohort we generated a set of about 300 neopeptides that emerged from frequent mutations (>5% in our cohort) with a strong binding affinity for at least one HLA type. We evaluated that a set of about 60 neopeptides per person from that list is predicted likely to initiate an immune response in ~99.5% of the carriers. These findings hold promise for the development of a preventive vaccine capable of targeting early tumorigenic stages. This work is approved under Weill Cornell IRB exemption 1810019672. Citation Format: Hagay Ladany, Mark Grossman, Julian Hess, Nicole Lu, Derin Keskin, Catherine J. Wu, Nir Hacohen, Richard Gallon, John Burn, Heather Hampel, Zsofia Stadler, Gad Getz, Yosef E. Maruvka, Steven Lipkin. Comparative molecular profiling of sporadic and Lynch syndrome MSI tumors: Unraveling insights for vaccine design [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4096.

PD-11 In depth analysis of label-free infrared (IR) imaging-based microsatellite instability (MSI) classification in early colon cancer (CC) on samples from the AIO ColoPredictPlus 2.0 (CPP) registry trial

MSI occurs in 15-20% of all early CC due to a deficient mismatch repair system and testing is now considered standard for all colon cancers as MSI is of prognostic and predictive value. Presently, protein analysis using immunohistochemistry targeting the mismatch repair proteins is most frequently used in routine clinical pathology with high sensitivity. Alternatively, fragment length analysis of microsatellite loci or next-generation sequencing can be used. All the techniques referred to are time and tissue consuming. We utilize label-free quantum cascade laser (QCL) based IR imaging combined with artificial intelligence (AI) approaches to test unstained tissue samples for MSI. IR imaging is an emerging microscopic technique based on the interaction of electromagnetic waves with the molecules within the tissue creating molecular fingerprints. To establish the methodological robustness of our approach, we analyzed samples from the multicentric prospective AIO ColoPredict Plus (CPP) 2.0 registry trial. IR imaging can analyze unstained paraffin-embedded tissue slides within an average of 30 min/slide. All tissue samples were obtained from the CPP registry trial. For development of the MSI/MSS classification model the cohort was split into a training, test, and validation set. The training set was utilized for the optimization of a modified VGG-16 convolutional neural network (CNN) with area under receiver operating characteristic (AUROC) and area under precision recall curve (AUPRC) evaluated on the test set as endpoints. The final classification model is validated on the validation set and in depth analyzed for sub-cohorts (BRAF, KRAS, UICC stage, grading). A cohort of 547 patients (training n=331 (43% MSI), test n=69 (43% MSI), validation n=147 (18% MSI)) was selected from CPP. Baseline characteristics including BRAF mutations, were balanced between training and test set, thus providing a balanced ground-truth for the training of the classifier. By contrast, the validation set (18% MSI) corresponds to the natural occurrence of MSI, showing a typically pattern for MSI and MSS with a higher proportion of female patients, more right-sided cases and more BRAF mutations for MSI-samples. The selected MSI/MSS classifier reached a validation AUROC of 0.90 (sensitivity 85%, specificity 84%) and AUPRC of 0.74. The AUROC of the sub-cohorts range between 0.78 and 0.99 (BRAF: 0.93 (wt), 0.78 (mt); KRAS: 0.84 (wt), 0.99 (mt); Grading: 0.93 (G2), 0.84 (G3); UICC Staging: 0.93 (II), 0.86 (III)). AI integrated IR imaging demonstrates a reliable classification performance for MSI/MSS with an AUROC of 0.90 (sensitivity 85%, specificity 84%) and robustness over sub-cohorts e.g., BRAF, KRAS, or staging. It further approaches the performance of the present gold standard immunohistochemistry. The combination of spatial and biochemical information encoded in the IR images allows CNNs to track changes on the molecular level. Additionally, this method requires fewer samples than other AI approaches and maintains intact tissue for further molecular analysis. Overall, this method has the potential to become an applicable diagnostic tool beyond the scope of known biomarkers for tumor-agnostic assessments.

Genetic Instability Markers in Cancer.

High frequency of mutations seems to determine a higher occurrence of neoepitope formation and, thus, tumor immunogenicity. A somatic hypermutated status could thus act as a predictive biomarker of responsiveness to immunotherapy with recent immune checkpoint inhibitors. Among several factors involved in determining the hypermutated status, such as inactivating mutations in the DNA polymerases as well as exposure to external (cigarette smoke, UV radiation, chemicals) and endogenous (reactive oxygen species) mutagens, a defective DNA mismatch repair system may give rise to genetic instability and, particularly, to microsatellite instability (MSI). The occurrence of MSI has been associated with increased load of mutations and expression of abundant peptides that serve as neoantigens to elicit an immune response within a context of a favorable tumor microenvironment. Here we describe methodological strategies to investigate for the presence of the MSI phenotype in cancer samples, through a combination of molecular approaches performed on paraffin-embedded tissues.

Analysis of microsatellite instability in CRISPR/Cas9 editing mice

Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR- associated (Cas) protein 9 system is a novel and powerful tool which is widely used for genome editing. CRISPR/Cas9 is RNA-guided and can lead to desired genomic modifications. However, whether the CRISPR/Cas9-mediated genome editing causes genomic alterations and genomic instability, such as microsatellite instability (MSI), is still unknown. Here we detected MSI in 21 CRISPR/Cas9 mouse strains using a panel of 42 microsatellite loci which were selected from our previous studies. Surprisingly, MSI occurrence was common in CRISPR/Cas9 modified genome, and most of the strains (19/21, 90.5%) examined showed MSI. Of 42 loci examined, 8 loci (8/42, 19.05%) exhibited MSI in the Cas9 editing mice. The Ttll9 (4/42, 9.5%) were the most unstable strains, and D10Mit3 and D10Mit198 (9/21, 42.9%) were considered to be the most “hot” loci in the Cas9 strains we tested. Through analyzing the mutation of microsatellite loci, we provide new insights into the genomic alterations of CRISPR/Cas9 models and it will help us for a better understanding of this powerful technology.

Microsatellite instability detected in tumor-related genes in C57BL/6J mice with thymic lymphoma induced by N-methyl-N-nitrosourea

Microsatellite instability (MSI) has been observed within tumors and found to be closely associated with the degree of malignancy and prognosis in tumors. However, whether MSI in tumor-related genes can be induced by a chemical and whether a connection exists between MSI and tumors remain unclear. In the present study, we detected MSI in the tissues of N-methyl-N-nitrosourea (MNU) treated mice by targeting to 5, 29, 30 microsatellite loci in 3 mismatch repair (MMR) genes, 1 DNA repair gene, and 5 tumor suppressor (TS) genes, respectively. Among 26 mice survived in the MNU-group, 18 (69%) mice presented thymic lymphomas. Moreover, 61% (11/18) of the tumors metastasized to the other organs, including the liver, spleen, and kidney. We examined 104 tissues from MNU-treated mice using the 64 loci, and found 8 MSI events involved 4 loci in 4 tissues types. The MSI incidence in MMR, DNA repair, and TS genes was 67% (2/3), 0% (0/1) and 40% (2/5), respectively. MSI occurrence in tumor and non-tumor tissues was 5.6% (1/18) and 0% (0/8) and that in metastasis and non-metastasis tissues was 7.1% (1/14) and 9.4% (6/64), showing no significant difference. MSI loci in intronic regions of Atm, Msh6 and p21 and MSI in the 3′UTR of Pms2 were detected in MNU-treated mice. Specifically, we found a loss of heterozygosity in intron of Atm (ATM-8) in one metastasis mouse. Four similar events occurred in p21 gene intron (P21-1) of another non-metastasis mouse. Another MSI was a heterozygous mutation existed in an Msh6 allele (MSH6-2) in metastasis mouse. We also found a homozygous 2-bp insertion in the 3′UTR of Pms2 in two non-metastasis mice. These results imply that MNU can induce MSI in MMR and TS genes in C57BL/6J mice. MSI frequency does not seem to be associated with tumorigenesis or metastasis.

Analysis of the relationship between microsatellite instability and thymic lymphoma induced by N-methyl-N-nitrosourea in C57BL/6J mice

Microsatellite instability (MSI) has been found to be closely associated with many types of human tumors and often shows strong correlations with specific tumor features. However, the relationship between MSI and tumors are still unclear. The aim of the present study is to explore the relationships between MSI, tumor formation under the mutagenic effects of N-methyl-N-nitrosourea (MNU). Mice were administered with either MNU (90mg/kg) or PBS and DMSO (control) at the beginning of the 1st week of the experiment. Of the 31 mice that survived the entire experimental time course, 19 (61.3%) mice developed thymic lymphomas. In addition, 52.6% (10/19) of the tumors had metastasized to the liver. We detected MSI in MNU-treated mice using a panel of 42 mutation-sensitive loci. Nineteen loci (45.2%) in six organs showed 70 MSI events. Locus D8Mit14 showed enhanced MSI compared with the other examined loci. MSI frequency in thymus was higher than in other organs. Interestingly, there was no significant difference observed between the metastatic and non-metastatic livers. The MSI frequency (4.6%, 23/(42×12)) in the MNU-treated thymus that had never developed tumor was significantly higher than this in the thymus that had developed lymphoma (0.5%, 4/(42×19)) (p<0.0001). These results indicate that, although thymic tumorigenesis is associated with MSI, it occurs with higher frequency in these that have not developed tumors upon the MNU-treatment. Our study provides additional insights into the relationship between MSI occurrence and tumorigenesis.

PHENOTYPIC FEATURES OF ENDOMETRIAL CANCER AND MSI IN COLON AND BLOOD SERUM

Since the end of the last century an upward trend regarding hormone-dependent tumours of the reproductive system, including endometrial cancer (EC) has been observed, with one of the trend reasons being increased number of mutations, in particular, microsatellite instability (MSI) – the consequence of unpaired nucleotides repair system gene inactivation (MSH2, MSH3, MSH6, MLH1,PMS2, EXO1).This molecular genetic phenomenon may also be characteristic of certain colon cancer forms, while being detectable not only in the tumour but also in blood, which may be of clinical interest as regards either determining risk groups in terms of other localization malignant tumours development, especially colon cancer, or early diagnostics of the said diseases. However, relationship between clinical, phenotypic and molecular risk factors for EC and colon cancer needs further studying.The aim of research – to estimate MSI frequency in blood serum and colonic mucosal lining in patients with EC.Materials and methods. 342 patients with I – IV stage EC aged between 30 and 80 underwent MSI determining in tumour tissue, blood serum and colonic mucosa by means of polymerase chain reaction method using primers for microsatellite sequence (ВАТ-25, ВАТ-26). Colonic mucosal lining samples were obtained by colonoscopy prior to surgical intervention.Genomic DNA purification from blood serum was performed using DNA purification kit produced by Silex M Scientific and Production Company (Russia), in accordance with manufacturer's instructions. PCR was performed by the standard procedure using Tertsik-2 programmable thermal cycler produced by DNA – Technology LTD, Russia. The studies were carried out at Virola laboratory at Kharkiv Medical Academy of Postgraduate Education. Ethics and Bioethics Committee permit (minutes No.4 of 18.04.2013, Kharkiv Medical Academy of Postgraduate Education). The obtained digital study results were processed by means of conventional variation statistics methods using the χ2 criterion.Results. Estimation of MSI occurrence frequency in the colon tissue showed that MSI- colonic tissue is significantly more frequent (93.9 %) compared to MSI+ (6.1 %), p&lt;0.01.Analysis of MSI occurrence frequency in case of EC showed that MSI is significantly more frequently observed in blood serum (10.8 % of cases) than in the colonic tissue (mucosal lining) (6.1 %). A similar pattern was observed also in cases with MSI+ tumour phenotype (MSI frequency in colonic mucosal lining made 12.2 %, whereas in blood serum – 29.6 %, p &lt;0.01).Analysis of indices in cases with MSI- tumour phenotype demonstrated inverse relation, i.e. genome microsatellite instability was more frequently observed in the colonic mucosal lining than in blood serum (p&lt;0.05).We have carried out analysis of the MSI occurrence frequency in colonic tissue depending on the EC phenotypic traits and risk factors. The obtained data on the MSI disorder occurrence frequency in colonic tissue in case of EC depending on the endometrial carcinoma risk factors demonstrated correlation with the majority of criteria, thus verifying the literature data on the presence of common pathogenetic mechanisms in case of EC and colon cancer.Conclusions. 1. MSI disorders in the colonic mucosal lining and blood serum are more frequently observed in case of EC MSI + phenotype.2. Similarity of pathogenesis in terms of EC and colon cancer is affected by similar phenotypic traits of patients as well as by MSI development.

Impact of hypoxia and long-term cultivation on the genomic stability and mitochondrial performance of ex vivo expanded human stem/stromal cells

Recent studies have described the occurrence of chromosomal abnormalities and mitochondrial dysfunction in human stem/stromal cells (SCs), particularly after extensive passaging in vitro and/or expansion under low oxygen tensions. To deepen this knowledge we investigated the influence of hypoxia (2% O2) and prolonged passaging (>P10) of human bone marrow stromal cells (BMSCs) and adipose-derived stromal cells (ASCs) on the expression of genes involved in DNA repair and cell-cycle regulation pathways, as well as on the occurrence of microsatellite instability and changes in telomere length. Our results show that hypoxic conditions induce an immediate and concerted down-regulation of genes involved in DNA repair and damage response pathways (MLH1, RAD51, BRCA1, and Ku80), concomitantly with the occurrence of microsatellite instability while maintaining telomere length. We further searched for mutations occurring in the mitochondrial genome, and monitored changes in intracellular ATP content, membrane potential and mitochondrial DNA content. Hypoxia led to a simultaneous decrease in ATP content and in the number of mitochondrial genomes, whereas the opposite effect was observed after prolonged passaging. Moreover, we show that neither hypoxia nor prolonged passaging significantly affected the integrity of the mitochondrial genome. Ultimately, we present evidence on how hypoxia selectively impacts the cellular response of BMSCs and ASCs, thus pointing for the need to optimize oxygen tension according to the cell source.

Lack of microsatellite instability in squamous cell vulvar carcinoma

Mutator phenotypes with microsatellite instability (MSI) are observed in a subset of solid tumors. The objective of our study was to investigate the occurrence of MSI in vulvar squamous cell carcinoma (VSCC) and a possible relation between MSI and the presence of human papilloma virus (HPV). DNA samples from 44 tissue specimens of the primary VSCC as well as from six metastatic lymph node samples were analysed and compared with matched reference DNA from blood samples. The MSI status was examined by polymerase chain reaction (PCR) using the Bethesda panel of five microsatellite markers. PCR products were analysed by fluorescent capillary electrophoresis. No microsatellite instability was detected in tumor samples or in metastatic lymph nodes from any of the VSCC patients examined. Microsatellite instability seems not to play a major role in the carcinogenesis of VSCC and is probably not associated with the HPV-related genetic background of this neoplasm.

Impaired DNA repair and genomic stability in hereditary tyrosinemia type 1

The autosomal recessive disorder, hereditary tyrosinemia type 1 (HT1), is caused by a defective fumarylacetoacetate hydrolase enzyme. Consequently intermediate metabolites such as fumarylacetoacetate, succinylacetone and p-hydroxyphenylpyruvic acid accumulate. Characteristic to HT1 is the development of hepatocellular carcinoma, irrespective of dietary intervention or pharmacological treatment. Carcinogenesis may occur through a chromosomal instability mutator phenotype or a microsatellite instability phenotype, and deficient DNA repair may be a contributing factor thereof. The purpose of this study was to investigate the expression of DNA repair proteins, and the possible occurrence of microsatellite instability in HT1. Gene expression analyses show low expression of hOGG1 and ERCC1 in HT1 patient lymphocytes. Results from microsatellite instability analyses show allelic imbalance on chromosome 7 of the fah−/− mouse genome, and instability of the D2S123, D5S346 and (possibly) D17S250 microsatellite markers, in HT1 patient lymphocytes.

Microsatellite instability and hMLH1 and hMSH2 expression in renal tumors

Defects in the function of mismatch repair (MMR) genes result in genetic instability, a common feature of malignant progression. This study was conducted to determine the frequency of genetic instability [defined as microsatellite instability (MSI)] and to evaluate the sensitivity/specificity of immunohistochemistry in predicting the deficiency in MMR genes in renal cortical tumors. A total of 51 surgically-resected renal tumors (27 clear cell, 10 papillary, 5 chromophobe carcinomas and 9 oncocytomas) were studied. We also analyzed the correlation with clinicopathological parameters, the MSI status (assessed by using 5 microsatellite markers: D2S123, D11S904, D3S1621, D3S1683 and BAT26), and the immunohistochemical expression of 2 major MMR genes [the human mutL homolog 1 (hMLH1) and the human mutS homolog 2 (hMSH2)]. Sixteen cases (31.4%) showed MSI: Three (5.9%) demonstrated a high level of MSI, 11 (21.6%) demonstrated a low level of MSI, 2 (3.9%) presented with a loss of heterozygosity, and the remaining 35 (68.6%) exhibited microsatellite stability. The loss of hMLH1 and hMSH2 immunohistochemical expressions was observed in 5/51 (9.8%) and 9/51 (17.6%) cases, respectively. The complete absence of both hMLH1 and hMSH2 immunohistochemical expressions was observed only in the 3 cases with a high level of MSI. This study showed that defects in MMR genes are involved in renal carcinogenesis and correlate with the occurrence of MSI.

Microsatellite instability and hMLH1 and hMSH2 expression in renal tumors

Defects in the function of mismatch repair (MMR) genes result in genetic instability, a common feature of malignant progression. This study was conducted to determine the frequency of genetic instability [defined as microsatellite instability (MSI)] and to evaluate the sensitivity/specificity of immunohistochemistry in predicting the deficiency in MMR genes in renal cortical tumors. A total of 51 surgically-resected renal tumors (27 clear cell, 10 papillary, 5 chromophobe carcinomas and 9 oncocytomas) were studied. We also analyzed the correlation with clinicopathological parameters, the MSI status (assessed by using 5 microsatellite markers: D2S123, D11S904, D3S1621, D3S1683 and BAT26), and the immunohistochemical expression of 2 major MMR genes [the human mutL homolog 1 (hMLH1) and the human mutS homolog 2 (hMSH2)]. Sixteen cases (31.4%) showed MSI: Three (5.9%) demonstrated a high level of MSI, 11 (21.6%) demonstrated a low level of MSI, 2 (3.9%) presented with a loss of heterozygosity, and the remaining 35 (68.6%) exhibited microsatellite stability. The loss of hMLH1 and hMSH2 immunohistochemical expressions was observed in 5/51 (9.8%) and 9/51 (17.6%) cases, respectively. The complete absence of both hMLH1 and hMSH2 immunohistochemical expressions was observed only in the 3 cases with a high level of MSI. This study showed that defects in MMR genes are involved in renal carcinogenesis and correlate with the occurrence of MSI.

Distribution of Microsatellite Instability in Danish Ovarian Tumor Patients and the Prognostic Value in Ovarian Cancer Patients

The repeated frequency of microsatellite instability (MSI) in ovarian cancer (OC) ranges from 0% to 50%. Most MSI studies including OC patients have involved relatively small number of tumors, a wide range of different MSI markers, different patient characteristics, and varying criteria for defining tumors as MSI positive. Thus, no conclusive evidence about MSI occurrence in OC has been provided and the large variation has made interpretation of these previous studies difficult. The majority of MSI studies have been performed on OC cases with few borderline ovarian tumor (BOT) cases included. Few BOT studies showed no evidence of MSI, but in one study the frequency of MSI was 27.7% with all tumors of serous type, suggesting that MSI may play a role in the development of serous BOT. The aim of our study was to determine the frequency of MSI using a panel of 16 dinucleotide markers: TP53, D17S250, CACNLB1, D18S58, D19S49, DXS538, DXS454, D5S117, D5S107, D6S284, D6S305, D9S171, D9S15, D11S554, D11S29, and D13S272 in tissue from patients with OC or BOT and to correlate the presence of MSI at these markers with the clinical information, such as FIGO stage, histological type, age, and survival in OC. The overall frequencies of MSI were within 2-10%. We observed MSI at different loci and with different extent (2.3-9.8%) in the different histopathological types. In both BOT and OC cases, we observed that all high MSI (MSI-H) were of serous type. No significant difference in disease specific survival was found between stage III/IV OC patients who presented MSI compared to patients being microsatellite stable (MSS) (p = 0.72). In conclusion, we found no association to any of the clinical parameters evaluated, although a tendency of a higher frequency of MSI was observed among serous OC.

Assessing the pathogenicity of MLH1 missense mutations in patients with suspected hereditary nonpolyposis colorectal cancer: correlation with clinical, genetic and functional features

Assessing the pathogenicity of missense mutations of MLH1 and MSH2 is critical to counsel patients with suspected hereditary nonpolyposis colorectal cancer (HNPCC). Approximately 32% of all MLH1 mutations and 18% of MSH2 mutations are missense variants which often have an uncertain genetic significance. To assess the pathogenicity of four MLH1 missense mutations which were found in five patients with suspected HNPCC, P648S (CCC --> TCC), L559R (CTG --> CGG), K618A (AAG --> GCG), Y646C (TAT --> TGT), we studied their ability to disrupt MLH1 protein function and their relationship with all those clinical, genetic and pathological features which are typical of this syndrome. Our results indicated that the P648S and L559R mutations were probably pathogenic because they disrupted MLH1 protein interaction with its partner PMS2 in vitro and abolished MLH1 expression in HCT116 cells. In addition these variants were associated with features often found in HNPCC patients: in particular high microsatellite instability, occurrence of high grade tumours and, in one case, strong family history. The pathogenicity of the K618A and Y646C mutations was questionable as their correlation with features typical of HNPCC was low and the outcome of the functional analysis was ambiguous. These observations suggested that a clinically usable assessment of the pathogenicity of MLH missense variants can be achieved through the analysis of multiple mutation characteristics among which loss of protein function, occurrence of microsatellite instability and family history seemed to have a predominant role.

Infrequent Microsatellite Instability in Urothelial Cell Carcinoma of the Bladder in Young Patients

ObjectiveDefects in the DNA mismatch repair result in microsatellite instability (MSI), which characterise most tumours related to the hereditary non-polyposis colorectal cancer syndrome and some sporadic tumours. Several studies have reported the occurrence of MSI in urothelial cell carcinoma (UCC) of the bladder with a particularly high incidence in tumours from young patients. In this study, we have evaluated the occurrence of MSI in primary bladder UCC arising in seventeen young patients selected for being below 45 years of age at diagnosis. MethodsMicrosatellite analysis has been performed using the panel of five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-24, NR-27) recently recommended to detect MSI tumours. The original Bethesda panel including BAT-25, BAT-26 and three dinucleotide repeats (D2S123, D5S346, D17S250) has further been studied in 10 UCC samples. ResultsMSI has been observed in only one of the 17 bladder UCC studied. Using the original Bethesda panel, identical results were obtained, indicating that the panel of five mononucleotide markers adequately detected MSI in UCC tumours. ConclusionsOur data indicate that classical MSI affecting mono- or di-nucleotides are rarely involved in bladder UCC developing in young patients. Further studies using gold standard criteria would help clarifying the involvement of MSI in the pathogenesis of bladder UCC.

Frequent microsatellite alterations in a predominantly younger age of onset breast cancer population.

Microsatellite instability (MSI) and loss of heterozygosity (LOH) was investigated in paired tumour and normal tissue DNA from 108 predominantly premenopausal breast cancer patients (under age 45 years at presentation) for 25 simple repeat loci interspersed across 11 chromosomes. MSI was observed at a single locus in 69 (64%) patients; 41 of these had instability at more than one site. Greatest frequency of MSI was at loci D2S1356 (33%), D2S2739 (22%), D3S1766 (21%) and D13S796 (20%). LOH was seen at a single site in 55% of patients and at two or more sites in 27 patients with greatest frequency at D2S1356 (33%), D2S443 (19%) and D17S1299 (18%). Both mutations were found in the same patient but at different loci. Clearly, choice of loci is a determining factor in assessing genomic instability. The relatively high frequency of MSI may also reflect peculiarities of this younger patient population. Occurrence of MSI or LOH was unrelated to clinical stage, nodal status, tumour size or grade or steroid receptor status. It was independent of mutations detected in exons 5-9 of the p53 gene. There was no significant association with survival. The lack of such correlations reflects a random disabling mechanism that may equally affect genes promoting cell death as well as growth.

Microsatellite instability is not a common feature in medullary breast cancer

Microsatellite instability (MSI) is a form of genomic instability associated with defective DNA mismatch repair in tumors. MSI is found in 85–90% of hereditary nonpolyposis colorectal cancer cases; however, its occurrence in breast carcinogenesis still remains to be clarified. In addition, data are limited on the incidence of MSI in the medullary subtype. The purpose of this study was to investigate the occurrence of MSI in medullary breast cancer (MBC). The study included a total of 16 patients with MBC, nine with typical and seven with atypical histology. The incidence of MSI in five microsatellite loci (D2S123, D3S1611, D17S807, D17S796 and Xq11-12) was determined by comparing paired normal and tumor tissue DNA after PCR amplification from paraffin-embedded tissues. All 16 tumors showed stability at five loci. Although the number of microsatellite markers and DNA samples may limit the value of our results, we conclude that the MSI phenotype is uncommon in human MBC.

Analysis of microsatellite instability in acquired drug-resistance human tumor cell lines

Genomic instability characterized as microsatellite instability (MIN) is associated with loss of DNA mismatch repair (MMR) protein. Several studies have shown that loss of DNA MMR protein confers resistance to some interacting DNA chemotherapeutic drugs, but also that exposure of MMR-proficient cells to these drugs can result in loss of MMR protein accompanied by induction of MIN. Such associations were mainly reported for cisplatin, but scarce data are available for doxorubicin (a DNA interacting agent), and nothing is known about vinblastine (an antitubulin agent). Thus, in this study we have analyzed MIN frequency in different type of human tumor cell lines characterized by their MMR protein status and resistant to doxorubicin or to vinblastine. Relationship between MIN occurrence and drug resistance was firstly verified in cisplatin resistant cells, and showed a MIN enrichment (33%) only in the MMR-deficient cells. In order to determine whether treatment of MMR-proficient cells with doxorubicin might lead to induction of MIN, we analyzed two different MMR-proficient cell lines. Variations of MIN frequency were found with either high levels of MIN (66%) or no MIN at all (0%). Effect of vinblastine was analyzed according to the MMR status in two different MMR-proficient and -deficient cells. No major change in MIN frequency was found either in the MMR-proficient (0%) or -deficient (9%) cells. Our results demonstrate that MIN occurs only in tumor cells resistant to cisplatin or doxorubicin, thus supporting earlier findings reporting such associations only with drugs interacting with DNA. Moreover, the data show that MIN does not appear in all tumor cell lines, suggesting that induction of MIN in relation to MMR status is a complex phenomenon which does not only depend on the drug considered (interacting or not with DNA), but also on the tumor cell variant.

Distinct Clinical Features and Outcomes of Gastric Cancers with Microsatellite Instability

Microsatellite instability (MSI) is a hallmark of the DNA mismatch repair deficiency that is one of the pathways of gastric carcinogenesis. Clinicopathologic characteristics of MSI+ gastric cancers remain unclear. To determine the correlation between MSI status and clinical features, we analyzed 327 consecutive gastric cancers for the occurrence of MSI in the BAT-26 marker. Because it has been proven that MSI at BAT-26 reflects the MSI+ phenotype, cancers with alteration at BAT-26 were categorized as having the MSI+ phenotype. The expressions of hMLH1, hMSH2, p53, MUC1, MUC2, and CEA were evaluated immunohistochemically using the tissue array method. The MSI+ phenotype was found in 9.5% (31/327) of gastric cancers examined. MSI+ gastric cancers were significantly associated with older age, antral location, Borrmann’s gross Type II, intestinal subtype, lower prevalence of lymph node metastasis, and lower pTNM stage (P < .05). By multivariate logistic regression, MSI+ gastric cancers had a lower prevalence of lymph node metastasis independent of tumor invasion (P < .001). MSI+ gastric cancers displayed frequent frameshift mutations of transforming growth factor-β type II receptor (90.3%), BAX (61.3%), hMSH3 (38.7%), and E2F4 (61.3%) genes and diminished hMLH1 (24/31) or hMSH2 (4/31) expressions. The MSI+ phenotype correlated with patient survival in advanced gastric carcinoma (P = .046). In conclusion, MSI+ phenotype in gastric cancers was found to have distinct clinicopathologic characteristics and to be predictive of a favorable outcome in advanced carcinoma.