Microsatellite instability in preneoplastic and neoplastic lesions of the gallbladder.
BACKGROUND
Gallbladder cancer is very common in Chile and is the leading cause of cancer deaths in women aged over 40 years. However, there is limited information about the molecular changes involved in its pathogenesis. Microsatellite analysis was performed using polymerase chain reaction (PCR)-based assays to identify genetic loci that were altered in neoplastic and preneoplastic conditions of early and advanced gallbladder cancer. Our findings were then correlated with clinicopathological variables and survival time.


METHODS
We selected 59 surgical specimens of gallbladder adenocarcinomas (29 early cancers and 30 advanced cancers) and 22 surgical specimens from patients with chronic cholecystitis from a high-risk area for gallbladder cancer (Temuco, Chile). Laser capture microdissection (LCM) was used to harvest tumor cells and preneoplastic lesions. Microsatellite analysis was performed using 13 different markers. The tumors and preneoplastic lesions were also examined with immunohistochemistry for hMLH1, hMSH2, and hMSH6.


RESULTS
We found that 10% (6/59) of gallbladder cancers showed high-frequency microsatellite instability (MSI-H), with identical proportions in both early and advanced cancers. In premalignant lesions adjacent to the six MSI-H tumors, we detected instability in two of six examples of intestinal metaplasia (33%) and five of six examples of dysplasia (83%). All MSI-H cases showed an altered pattern with the antibodies studied. MSI status was not associated with survival or other clinicopathological features. No MSI or immunohistochemical alterations were found in the chronic cholecystitis group.


CONCLUSIONS
Microsatellite instability was observed in equal proportions in early and late cancers, and it was also found in premalignant lesions, indicating that inactivation of mismatch repair genes occurs early in gallbladder carcinogenesis.
Roa
Juan Carlos
JC
Department of Pathology, Universidad de la Frontera, Faculty of Medicine, Manuel Montt 112, Temuco, Chile.
Roa
Iván
I
Correa
Pelayo
P
Vo
Quynh
Q
Araya
Juan Carlos
JC
Villaseca
Miguel
M
Guzmán
Pablo
P
Schneider
Barbara G
BG
D000230:Adenocarcinoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002677:Chile / Q000453:epidemiology; D002764:Cholecystitis / Q000235:genetics / Q000401:mortality / Q000473:pathology; D004268:DNA-Binding Proteins / Q000378:metabolism; D005260:Female; D005706:Gallbladder Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D042822:Genomic Instability / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D018895:Microsatellite Repeats / Q000235:genetics*; D008875:Middle Aged; D051718:MutS Homolog 2 Protein / Q000378:metabolism; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D013223:Statistics as Topic; D016019:Survival Analysis
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C094443:G-T mismatch-binding protein; C497172:MSH2 protein, human; D051718:MutS Homolog 2 Protein