Clinical Journal of Gastroenterology

, Volume 6, Issue 2, pp 122–126 | Cite as

Gastric cancers with microsatellite instability sharing clinical features, chemoresistance and germline MSH6 variants

  • Kentaro Yamashita
  • Yoshiaki Arimura
  • Mayuko Saito
  • Hiromu Suzuki
  • Tomohisa Furuhata
  • Koichi Hirata
  • Yasuhisa Shinomura
Case Report


Recent studies suggest that colorectal cancer with microsatellite instability (MSI) might be resistant to fluorouracil-based chemotherapy; however, little is known about the clinical significance of MSI analysis for gastric cancer. We therefore conducted a prospective single center study analyzing MSI in gastric cancer. Of 123 consecutive gastric cancers analyzed, 12 (9.8 %) were MSI-positive and two patients with MSI-positive gastric cancer underwent systemic chemotherapy because of unresectable disease. Neither cases had concurrent nor past history of other malignancies but one had cancer family history meeting the revised Bethesda criteria. These two MSI-positive gastric cancers shared multiple clinical features, such as direct invasion to adjacent organs, extensive nodal metastasis but no distant metastasis, resistance to fluorouracil and death of tumor bleeding. The two cases had unmethylated MLH1 promoter, suggestive of Lynch syndrome. Germline mutation analysis demonstrated MSH6 alterations of unknown significance in both cases.


Gastric cancer Microsatellite instability Lynch syndrome 


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Kentaro Yamashita
    • 1
  • Yoshiaki Arimura
    • 1
  • Mayuko Saito
    • 1
  • Hiromu Suzuki
    • 2
  • Tomohisa Furuhata
    • 3
  • Koichi Hirata
    • 3
  • Yasuhisa Shinomura
    • 1
  1. 1.First Department of Internal MedicineSapporo Medical UniversitySapporoJapan
  2. 2.Department of Molecular BiologySapporo Medical UniversitySapporoJapan
  3. 3.First Department of SurgerySapporo Medical UniversitySapporoJapan

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