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World J Gastroenterol. Nov 28, 2014; 20(44): 16433-16442
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16433
Causes and consequences of microsatellite instability in gastric carcinogenesis
Sérgia Velho, Maria Sofia Fernandes, Marina Leite, Ceu Figueiredo, Raquel Seruca
Sérgia Velho, Maria Sofia Fernandes, Marina Leite, Ceu Figueiredo, Raquel Seruca, IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, 4200-465 Porto, Portugal
Ceu Figueiredo, Raquel Seruca, Department of Pathology and Oncology, Faculty of Medicine of the University of Porto, 4200-465 Porto, Portugal
Author contributions: Velho S and Fernandes MS contributed equally to this paper; Velho S, Fernandes MS, and Leite M wrote the manuscript; Figueiredo C and Seruca R critically revised the manuscript.
Supported by FEDER through Programa Operacional Factores de Competitividade - COMPETE, and National Funds, No. FCOMP-01-0124-FEDER-000022; and Grants from Fundação para a Ciência e a Tecnologia (FCT), No. IF/00136/2013 (to Velho S), No. SFRH/BPD/63716/2009 (to Fernandes MS) and No. SFRH/BPD/33420/2008 (to Leite M)
Correspondence to: Raquel Seruca, MD, PhD, IPATIMUP- Institute of Molecular Pathology and Immunology of the University of Porto, Rua D. Manuel II s/n, 4200-465 Porto, Portugal. rseruca@ipatimup.pt
Telephone: +351-22-5570700
Received: May 30, 2014
Revised: July 24, 2014
Accepted: September 5, 2014
Published online: November 28, 2014
Abstract

Loss of DNA mismatch repair (MMR) function, due to somatic or germline epi/genetic alterations of MMR genes leads to the accumulation of numerous mutations across the genome, creating a molecular phenotype known as microsatellite instability (MSI). In gastric cancer (GC), MSI occurs in about 15% to 30% of the cases. This review summarizes the current knowledge on the molecular mechanisms underlying the acquisition of MSI in GC as well as on the clinic, pathologic and molecular consequences of the MSI phenotype. Additionally, current therapeutic strategies for GC and their applicability in the MSI subset are also discussed.

Keywords: Gastric cancer, Microsatellite instability, Mismatch repair genes, Oncogenes, Helicobacter pylori

Core tip: This review summarizes the current knowledge on the molecular mechanisms underlying the acquisition of microsatellite instability (MSI) in gastric cancer (GC) as well as on the clinic, pathologic and molecular consequences of the MSI phenotype. Additionally, current therapeutic strategies for GC and their applicability in the MSI subset are also discussed.