Regional reproducibility of microsatellite instability in sporadic colorectal cancer.

The reproducibility of microsatellite instability from different regions of the same sporadic colon cancer has not been addressed. We therefore microdissected and extracted DNA from three to nine separate regions of 13 highly unstable sporadic colon cancers. Each region was then evaluated by polymerase chain reaction amplification of 17 microsatellites: 10 tetranucleotide repeats, 2 noncoding mononucleotide repeats (BAT-26 and BAT-40), and 5 coding mononucleotide repeats (TGFBRII, BAX, MSH3, MSH6, IGFIIR). Microsatellite instability showed 100% regional reproducibility with respect to either the panel of 10 tetranucleotide repeats or BAT-26, and nearly 100% reproducibility with BAT-40, although regional variation in the percent instability and the size of unstable alleles was present. TGFBRII was more frequently mutated than any other coding mononucleotide repeat; frame shifts in this gene were identified in nearly every region of every tumor. Each of the five coding repeats showed regional variability in at least one tumor, and 10 of the 13 tumors showed variability with at least one coding repeat. This variability took the form of different mutant alleles (TGFBRII, BAX, MSH3) or mutations present in some but not all regions of a tumor (MSH6, IGFIIR, BAX, MSH3). We conclude that the regional reproducibility of generalized microsatellite instability as measured by noncoding repeats indicates that sampling is not a problem in these highly unstable tumors, and that the mismatch repair deficiency phenotype is acquired in the very late adenoma stage or early cancer stage of sporadic colonic tumorigenesis. The high frequency of TGFBRII mutations is consistent with acquisition of these mutations at a similar stage of tumorigenesis. The regional variability with respect to the presence or absence of a mutation in the other four coding mononucleotide repeats could lead to sampling error and is consistent with a somewhat later time of acquisition of these mutations. Genes Chromosomes Cancer 26:106-114, 1999.