title: Microsatellite instability is associated with the clinicopathologic features of gastric cancer in sporadic gastric cancer patients.
abstract: OBJECTIVE
  Replication error is an important mechanism in carcinogenesis. The microsatellite instability (MSI-H) of colorectal cancers is associated with the development of multiple cancers. The influence of MSI-H on the development of multiple gastric cancers in sporadic gastric cancer patients has not been defined. This study was performed to reveal the association between the clinicopathologic features and MSI in sporadic gastric cancers.
  
  
  METHODS
  Between July 2004 and March 2009, the clinicopathologic characteristics, including MSI status, were evaluated in 128 consecutive patients with sporadic gastric cancers. None of the patients had hereditary non-polyposis colorectal cancer of familial gastric cancer. The markers that were recommended by the NCI to determine the MSI status for colorectal cancers were used.
  
  
  RESULTS
  MSI-H cancers were found in 10.9% of the patients (14/128). Synchronous gastric cancers were shown in 4 patients (3.1%). Synchronous cancers were found in 2 of 14 patients with MSI-H gastric cancer (14.3%) and 2 of 114 patients with MSS gastric cancer (1.8%; P=0.059, Fisher's exact test). Among the patients with synchronous cancer 50% (2/4) had MSI-H cancer, but 9.7% of the patients (12/124) without synchronous cancer had MSI-H cancer. MSI-H (RR, 24.7; 95% CI, 1.5~398.9; P=0.024) was related with to synchronous gastric cancer, but age, gender, family history, histologic type, location, gross morphology, size, and stage were not related to synchronous gastric cancer.
  
  
  CONCLUSIONS
  MSI is associated with the intestinal-type gastric cancer and the presence of multiple gastric cancers in patients with sporadic gastric cancer. Special attention to the presence of synchronous and the development of metachronous multiple cancer in patients with MSI-H gastric cancer is needed.
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Shin Hyuk
authors.initials: SH
authors.lastname: Kim
authors.forename: Byung Kyu
authors.initials: BK
authors.lastname: Ahn
authors.forename: Young Su
authors.initials: YS
authors.lastname: Nam
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Pyo
authors.forename: Young Ha
authors.initials: YH
authors.lastname: Oh
authors.forename: Kang Hong
authors.initials: KH
authors.lastname: Lee
references.citation: Cancer Res. 1998 Nov 15;58(22):5248-57
references.pmid: 9823339
references.citation: J Cancer Res Clin Oncol. 1993;119(5):265-72
references.pmid: 8440743
references.citation: Am J Surg. 1975 Jun;129(6):686-90
references.pmid: 1130613
references.citation: Acta Pathol Microbiol Scand. 1965;64:31-49
references.pmid: 14320675
references.citation: J Gastrointest Surg. 2007 Mar;11(3):233-9
references.pmid: 17458592
references.citation: Gastroenterology. 1993 May;104(5):1535-49
references.pmid: 8482467
references.citation: Int J Cancer. 2001 Nov 20;95(6):350-3
references.pmid: 11668515
references.citation: Int J Cancer. 1999 Mar 31;81(1):1-5
references.pmid: 10077143
references.citation: Cancer Res Treat. 2001 Oct;33(5):367-72
references.pmid: 26680809
references.citation: Eur J Cancer. 1997 Dec;33(14):2342-6
references.pmid: 9616279
references.citation: Surg Today. 1993;23(2):186-8
references.pmid: 8467167
references.citation: Br J Surg. 1995 Nov;82(11):1540-3
references.pmid: 8535813
references.citation: Cancer Res Treat. 2006 Feb;38(1):25-9
references.pmid: 19771255
references.citation: Histopathology. 2003 Feb;42(2):128-36
references.pmid: 12558744
references.citation: Br J Surg. 1997 Jul;84(7):996-1000
references.pmid: 9240146
references.citation: Eur J Surg Oncol. 1989 Aug;15(4):316-21
references.pmid: 2547661
references.citation: Cancer Res. 1994 Sep 1;54(17):4595-7
references.pmid: 8062248
references.citation: Am J Gastroenterol. 1995 Apr;90(4):653-6
references.pmid: 7717330
references.citation: Am J Pathol. 1998 Oct;153(4):1211-9
references.pmid: 9777952
references.citation: Gastroenterology. 2002 Dec;123(6):1804-11
references.pmid: 12454837
references.citation: Gastric Cancer. 1998 Dec;1(1):10-24
references.pmid: 11957040
references.citation: Am J Gastroenterol. 1999 Oct;94(10):3034-8
references.pmid: 10520865