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Molecular Biology and Genetics |
Dana Farber Cancer Institute [S. S. W., G. T., M. L., J. G., S. S., E. F.], Brigham and Womens Hospital [G. T., M. L., S. S.], Harvard Medical School, Boston, Massachusetts 02115, and Ludwig Institute of Cancer Research [S. S. W., J. S., R. D. K.], Department of Medicine [R. D. K.] and Cancer Center [R. D. K.], University of California San Diego School of Medicine, La Jolla, California 92903
Forty-eight hereditary nonpolyposis colorectal carcinoma (HNPCC) familiesfor which a tumor sample was available were evaluated for the presence of germ-line mutations in MSH2 and MLH1, tumor microsatellite instability (MSI), and where possible, expression of MSH2 and MLH1 in tumors by immunohistochemistry. Fourteen of 48 of the families had a germ-line mutation in either MSH2 or MLH1 that could be detected by genomic DNA sequencing, and 28 of 48 of the families had MSI-H tumors. Four additional families showed loss of expression of MSH2, and one additional family showed loss of expression of MLH1 but did not have germ-line mutations in MSH2 or MLH1 that could be detected by DNA sequencing. MSI-H, as defined using the National Cancer Institute recommended five-microsatellite panel, had a 100% sensitivity for identifying samples having MSH2 or MLH1 mutations or loss of expression. In contrast, loss of MSH2 and MLH1 expression did not identify all samples having germ-line mutations in MSH2 or MLH1, because in five cases, a mutant protein product was expressed that could be detected by IHC. A combination of the Bethesda criteria for HNPCC and an MSI-H phenotype defined the smallest number of cases having all of the germ-line MSH2 and MLH1 mutations that could be detected by DNA sequencing.
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