title: High incidence of microsatellite instability in colorectal cancer from African Americans.
abstract: OBJECTIVE
  Colorectal carcinoma (CRC) is the second most common cause of cancer death in the United States, and the rate of CRC is nearly 1.5 times higher in African-Americans (AA) than in Caucasians. Microsatellite instability (MSI) is observed in sporadic CRC reflecting promoter hypermethylation of the DNA mismatch repair gene hMLH1, and anecdotal evidence suggests an increased incidence of MSI among AAs. Additionally, p16 can be inactivated by hypermethylation of the promoter region, abrogating its ability to regulate cell proliferation. The objective of this study is to determine the frequency of MSI and p16 gene methylation in CRC from AA patients.
  
  
  METHODS
  Experiments were conducted on serially collected archival samples of colon cancer and adjacent normal tissue (n = 22). Five microsatellite markers were used to measure MSI in tumors with direct comparison to normal tissue from the same patient. p16 promoter methylation status was determined by methylation-specific PCR.
  
  
  RESULTS
  Ten cancers (45%) demonstrated high MSI (MSI-H), 1 demonstrated low MSI, and the remaining 11 tumors were microsatellite stable. Most of the MSI-H tumors were proximal, well differentiated, and showed high levels of mucin production. Most patients in the MSI-H group were female (70%), whereas most of the microsatellite-stable group (81%) were male. Five of the 22 tumors (22%) had methylation of the p16 promoter.
  
  
  CONCLUSIONS
  Data provided here demonstrated that the incidence of MSI-H tumors was 3-fold higher in our study group of AA patients compared with data reported in nonracially selected but serially collected studies. Odds ratio analysis indicates that the chance of female patients having MSI-H was 11.7 times more than male patients (P < 0.03). The reason for this gender difference is unknown. These findings might reflect dietary differences or genetic polymorphisms that may be common in the AA population. Additional investigation in a larger patient population is needed before strong conclusion can be drawn.
authors.affiliation: Cancer Center and Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue NW, Washington, DC 20060, USA. hashktorab@howard.edu
authors.forename: Hassan
authors.initials: H
authors.lastname: Ashktorab
authors.forename: Duane T
authors.initials: DT
authors.lastname: Smoot
authors.forename: John M
authors.initials: JM
authors.lastname: Carethers
authors.forename: Majid
authors.initials: M
authors.lastname: Rahmanian
authors.forename: Rick
authors.initials: R
authors.lastname: Kittles
authors.forename: Greg
authors.initials: G
authors.lastname: Vosganian
authors.forename: Menaham
authors.initials: M
authors.lastname: Doura
authors.forename: Emmanel
authors.initials: E
authors.lastname: Nidhiry
authors.forename: Tammy
authors.initials: T
authors.lastname: Naab
authors.forename: Bahram
authors.initials: B
authors.lastname: Momen
authors.forename: Shahid
authors.initials: S
authors.lastname: Shakhani
authors.forename: Francis M
authors.initials: FM
authors.lastname: Giardiello
authors.forename: Shahed
authors.initials: S
authors.lastname: Shakhani
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000368:Aged; D044383:Black People; D002352:Carrier Proteins; D002454:Cell Differentiation; D002455:Cell Division; D003110:Colonic Neoplasms / Q000235:genetics / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000235:genetics*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D019175:DNA Methylation; D005260:Female; D006801:Humans; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism; D000070957:MutL Protein Homolog 1; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000235:genetics; D009687:Nuclear Proteins; D001741:Black or African American
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D002352:Carrier Proteins; D019941:Cyclin-Dependent Kinase Inhibitor p16; C501486:MLH1 protein, human; D009077:Mucins; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D000070957:MutL Protein Homolog 1