Somatic mutations in MLH1 and MSH2 are a frequent cause of mismatch-repair deficiency in Lynch syndrome-like tumors

Arjen R Mensenkamp, Ingrid P Vogelaar, Wendy A G van Zelst-Stams, Monique Goossens, Hicham Ouchene, Sandra J B Hendriks-Cornelissen, Michael P Kwint, Nicoline Hoogerbrugge, Iris D Nagtegaal, Marjolijn J L Ligtenberg
Gastroenterology 2014, 146 (3): 643-646.e8
Lynch syndrome is caused by germline mutations in the mismatch repair (MMR) genes. Tumors are characterized by microsatellite instability (MSI). However, a considerable number of MSI-positive tumors have no known molecular mechanism of development. By using Sanger and ion semiconductor sequencing, 25 MSI-positive tumors were screened for somatic mutations and loss of heterozygosity in mutL homolog 1 (MLH1) and mutS homolog 2 (MSH2). In 13 of 25 tumors (8 MLH1-deficient and 5 MSH2-deficient tumors), we identified 2 somatic mutations in these genes. We conclude that 2 acquired events explain the MMR-deficiency in more than 50% of the MMR-deficient tumors without causal germline mutations or promoter methylation.

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