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a Cancer
and Immunogenetics Laboratory, Imperial Cancer Research Fund, Institute
of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK, b Department of Medical Genetics, Haartman
Institute, University of Helsinki, Finland, c Department of Colorectal Surgery,
John Radcliffe Hospital, Oxford, UK
Correspondence to: Dr Wheeler, wheelerj{at}icrf.icnet.uk
Revised version received 29 March 2000;
Accepted for publication 10
April 2000
INTRODUCTION
Hypermethylation of
the promoter region of the hMLH1 gene is
associated with absent expression of MLH1 protein in sporadic colorectal cancers with microsatellite instability (MSI+), and it has
been proposed that methylation may be a mechanism of inactivation in
Knudson's hypothesis. The incidence of hypermethylation of the
hMLH1 promoter in hereditary non-polyposis
colorectal cancer (HNPCC) versus MSI+ sporadic colorectal cancer was
investigated and compared.
METHODS
DNA was available from 10 HNPCC colorectal cancers (median age 58 years, range 39-67) with
germline mutations in hMLH1 and 10 MSI+
sporadic colorectal cancers (mean age 79 years, range 41-85). MSI was
determined by amplification of BAT26 and TGF-
RII. The methylation
status of the hMLH1 promoter was studied by
the polymerase chain reaction (PCR) based
HpaII restriction enzyme assay technique.
Evidence of allelic loss at hMLH1 was searched for in the HNPCC colorectal cancers.
RESULTS
All cases were confirmed to
be MSI+. The promoter region of hMLH1 was
hypermethylated in seven of 10 MSI+ sporadic cancers versus 0 of 10 HNPCC cancers (p<0.002). Evidence of loss of heterozygosity at
hMLH1 was observed in eight of the 10 HNPCC
colorectal cancers.
CONCLUSION
While mutations and
allelic loss are responsible for the MSI+ phenotype in HNPCC cancers,
the majority of MSI+ sporadic cancers are hypermethylated in the
promoter region of hMLH1. These data further
support our argument that tumours from HNPCC patients, which almost
always acquire a raised mutation rate, mostly follow a different
pathway from MSI+ sporadic tumours.
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