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. 2005 Jul 14;11(26):3998-4002.
doi: 10.3748/wjg.v11.i26.3998.

Microsatellite instable double primary cancers of the colorectum and stomach exhibit less favorable outcome

Young-Ho Kim  1 , Sang-Yong Song, Young-Dae Kwon, Dae-Shick Kim, Ho-Kyung Chun, Jong-Chul Rhee
Affiliations

Microsatellite instable double primary cancers of the colorectum and stomach exhibit less favorable outcome

Young-Ho Kim et al. World J Gastroenterol. .

Abstract

Aim: To ascertain the adequacy of the microsatellite instability (MSI) as a prognostic indicator by assessing MSI status of patients with double primary gastric and colorectal cancer (DPGCC).

Methods: Sixteen patients were studied, all of whom exhibited sporadic DPGCC, and had no family history of hereditary non-polyposis colorectal cancer, according to the Amsterdam criteria. A total of 32 cancers from 16 DPGCC patients, and 216 single primary CRC, were assessed for MSI in 5 microsatellite loci, BAT25, BAT26, D2S123, D5S346, and D17S250.

Results: MSI was observed in 6 (37.5%) of 16 GC and 4 (25.0%) of 16 CRC. Thirty tumors (13.9%) out of 216 single primary CRC and one tumor (16.7%) out of 6 double primary CRC were found to be microsatellite unstable. Of the 6 GC with MSI in DPGCC, 5 (31.3%) were MSI-high and one (6.3%) was MSI-low. In 5 of 16 DPGCC patients, the cancer recurred in or adjacent to the anastomosis or metastasized to the kidney or lung. The MSI-high DPGCC cases were associated with a younger age of onset (47.5 years vs 62.5 years), higher frequency of lymph node metastasis (100% vs 25%), and advanced Dukes stage (C, 100% vs 41.7%), as well as a higher frequency of recurrence or metastasis (100% vs 8.3%). Only recurrence or metastasis showed statistical significance by Fisher's exact test.

Conclusion: Our data suggest that MSI may play an important role in the development of DPGCC, and that it may be used clinically as a molecular predictive marker for recurrence or late metastasis of DPGCC.

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Figures

Figure 1
Figure 1
Typical results of microsatellite instability (MSI) of tumors. A: Abnormal MSI peaks (arrows) of gastric cancer from case 4; B: Abnormal MSI peaks (arrows) of colonic cancer from case 2(upper raw: normal tissue, middle raw: cancer tissue, low raw: upper raw + middle raw).
See this image and copyright information in PMC

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