The role of microsatellite instability in gastric low- and high-grade lymphoma development

DNA mismatch repair genes and their dysfunction as evidenced by microsatellite instability (MSI) play an important role in the pathogenesis of a variety of tumors, most prominently hereditary nonpolyposis colorectal cancer (HNPCC). However, their role in development of extranodal lymphomas has not been established yet. We therefore evaluated for MSI 25 gastric low-grade marginal-zone B-cell lymphomas of mucosa-associated lymphoid tissue type and 31 gastric high-grade diffuse large B-cell lymphomas (DLBCLs) with 29 and 118 microsatellites, respectively. Compared with HNPCC, the overall level of MSI was much lower with a mean of 2.6% MSI-positive repeats in the DLBCLs; the frequency of MSI showed a tendency to increase with age (P = 0.01), as did MSI variability (P = 0.02). Low-grade mucosa-associated lymphoid tissue lymphomas displayed even less MSI (sevenfold) than DLBCLs (P = 0.009). MSI frequency thus increases with the transition from low- to high-grade disease and with age; it does not seem to initiate lymphomagenesis. Other microsatellites than those typically mutated in HNPCC frequently revealed MSI in these lymphomas, especially dinucleotide repeats on chromosomes 3, 5, and 18. To facilitate rapid screening of lymphomas for MSI and to establish a tool for future MSI frequency comparisons, we recommend to use repeats D3S1261, D3S1530, D5S346, D17S250, D18S474, and DCC.