Microsatellite instability in pulmonary adenocarcinomas: a comprehensive study of 480 cases

A major molecular pathway of genetic instability in cancer is DNA mismatch repair deficiency, leading to accumulation of numerous mutations at repetitive DNA sequence stretches (microsatellites), known as high-level microsatellite instability (MSI-H). In colorectal cancer, MSI-H tumors show a clinic...

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Hauptverfasser: Warth, Arne (VerfasserIn) , Körner, Sandrina (VerfasserIn) , Penzel, Roland (VerfasserIn) , Muley, Thomas (VerfasserIn) , Dienemann, Hendrik (VerfasserIn) , Schirmacher, Peter (VerfasserIn) , Knebel Doeberitz, Magnus von (VerfasserIn) , Weichert, Wilko (VerfasserIn) , Kloor, Matthias (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2016
In: Virchows Archiv
Year: 2016, Jahrgang: 468, Heft: 3, Pages: 313-319
ISSN:1432-2307
DOI:10.1007/s00428-015-1892-7
Online-Zugang:Verlag, Volltext: https://doi.org/10.1007/s00428-015-1892-7
Verlag, Volltext: https://link.springer.com/article/10.1007%2Fs00428-015-1892-7
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Verfasserangaben:Arne Warth, Sandrina Körner, Roland Penzel, Thomas Muley, Hendrik Dienemann, Peter Schirmacher, Magnus von Knebel-Doeberitz, Wilko Weichert, Matthias Kloor

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520 |a A major molecular pathway of genetic instability in cancer is DNA mismatch repair deficiency, leading to accumulation of numerous mutations at repetitive DNA sequence stretches (microsatellites), known as high-level microsatellite instability (MSI-H). In colorectal cancer, MSI-H tumors show a clinical behavior different from microsatellite-stable (MSS) tumors. Data about the prevalence of MSI among non-small cell lung cancer (NSCLC) are conflicting, and clinical relevance of MSI is largely unknown. We analyzed a series of 480 pulmonary adenocarcinomas (ADC) for MSI using a sensitive mononucleotide marker panel (BAT25, BAT26, and CAT25). Positive cases were further analyzed by immunohistochemical staining for DNA mismatch repair proteins. Results were correlated with clinicopathological variables. MSI-H was detected in 4/480 (0.8 %) cases. In none of these, a background of Lynch syndrome was found. Three of the patients developed a metachronous carcinoma (esophagus, pancreas, and kidney). All MSI-H cases were stage I and occurred in smokers/ex-smokers. Mutations were found in EGFR (n = 2), KRAS (n = 1), or BRAF (n = 1). MSI-H neoplasms had a higher proliferative activity (38.7 %) than MSS neoplasms (28.3 %). Mean overall survival for MSS and MSI-H cases was 64.8 (CI 60.4-69.1) and 47.1 (CI 21-73.2) months, respectively. When specific mononucleotide marker panels are applied, the MSI-H phenotype is rare and predominantly found in early stage ADC of smokers. However, the frequency of MSI-H is in the range of other relevant molecular alterations. In the era of precision therapy, associations with distinct clinicopathological variables merit further investigation. 
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