胃癌中的微卫星不稳定性以及MLH1和MSH2的表达改变
Microsatellite Instability and Altered Expressions of MLH1 and MSH2 in Gastric Cancer.
作者信息
Haron Nor Hasyimah, Mohamad Hanif Ezanee Azlina, Abdul Manaf Mohd Rizal, Yaakub Jasmi Ali, Harun Roslan, Mohamed Ramelah, Mohamed Rose Isa
机构信息
Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia.
UKM Medical Molecular Biology Institute (UMBI), University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur. Email:
出版信息
Asian Pac J Cancer Prev. 2019 Feb 26;20(2):509-517. doi: 10.31557/APJCP.2019.20.2.509.
Introduction: Microsatellite instability (MSI) is a hallmark of defective DNA mismatch repair (MMR) of genes especially MLH1 and MSH2. It is frequently involved in the carcinogenesis of various tumours including gastric cancer (GC). However, MSI in GCs have not been reported in Malaysia before. Objective: This study was conducted to determine the microsatellite instability (MSI) status in gastric cancer by microsatellite analysis, sequencing, its association with MLH1 and MSH2 protein expression and H.pylori infection by immunohistochemistry. Method: A total of 60 gastric cancer cases were retrieved. DNA was extracted from paired normal and tumour tissues while MLH1 and MSH2 protein expression as well as H. pylori status were determined by IHC staining. For microsatellite analysis, polymerase chain reaction (PCR) was performed for paired tissue samples using a panel of five microsatellite markers. MSI-positive results were subjected for DNA sequencing to assess mutations in the MLH1 and MSH2 genes. Results: Microsatellite analysis identified ten MSI positive cases (16.7%), out of which only six cases (10.3%) showed absence of MLH1 (n=3) or MSH2 (n=3) protein expression by IHC. The most frequent microsatellite marker in MSI positive cases was BAT26 (90%). Nine of ten MSI positive cases were intestinal type with one diffuse and all were located distally. H. pylori infection was detected in 13 of 60 cases (21.7%) including in three MSI positive cases. All these results however were not statistically significant. Our sequencing data displayed novel mutations. However these data were not statistically correlated with expression levels of MLH1 and MSH2 proteins by IHC. This may be due to small sample size to detect small or moderately sized effects. Conclusion: The frequency of MSI in this study was comparable with published results. Determination of affected MMR genes by more than two antibodies may increase the sensitivity of IHC to that of MSI analysis.
引言
微卫星不稳定性(MSI)是基因尤其是MLH1和MSH2的DNA错配修复(MMR)缺陷的标志。它经常参与包括胃癌(GC)在内的各种肿瘤的致癌过程。然而,此前马来西亚尚未有关于胃癌中MSI的报道。目的:本研究通过微卫星分析、测序来确定胃癌中的微卫星不稳定性(MSI)状态,通过免疫组织化学确定其与MLH1和MSH2蛋白表达以及幽门螺杆菌感染的关系。方法:共收集60例胃癌病例。从配对的正常组织和肿瘤组织中提取DNA,同时通过免疫组化染色确定MLH1和MSH2蛋白表达以及幽门螺杆菌状态。对于微卫星分析,使用一组五个微卫星标记对配对组织样本进行聚合酶链反应(PCR)。MSI阳性结果进行DNA测序以评估MLH1和MSH2基因的突变。结果:微卫星分析鉴定出10例MSI阳性病例(16.7%),其中仅6例(10.3%)通过免疫组化显示MLH1(n = 3)或MSH2(n = 3)蛋白表达缺失。MSI阳性病例中最常见的微卫星标记是BAT26(90%)。10例MSI阳性病例中有9例为肠型,1例为弥漫型,且均位于远端。60例病例中有13例(21.7%)检测到幽门螺杆菌感染,其中包括3例MSI阳性病例。然而,所有这些结果均无统计学意义。我们的测序数据显示了新的突变。然而,这些数据与免疫组化检测的MLH1和MSH2蛋白表达水平无统计学相关性。这可能是由于样本量小,无法检测到小的或中等大小的效应。结论:本研究中MSI的频率与已发表的结果相当。使用两种以上抗体确定受影响的MMR基因可能会提高免疫组化相对于MSI分析的敏感性。