<Original Paper>Microsatellite instability in ovarian serous carcinoma predicts resistance to cisplatin-based chemotherapy

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Background. An abnormality in the DNA mismatch repair system may be involved in resistance to anti-cancer agents, because the anti-cancer effects of chemotherapy are often dependent upon the generation of DNA damage, which is recognized by the DNA mismatch repair system. To clarify the mechanism of cisplatin (CDDP) resistance in ovarian cancer, we examined microsatellite instability (MSI) in the most frequent histologic subtype, ovarian serous adenocarcinomas (OSC). Methods. We studied 63 cases of OSC, and MSI was examined by polymerase chain reaction using 10 microsatellite markers (3 mononucleotide repeat and 7 dinucleotide repeat microsatellite markers). Results. Fifteen OSC cases showed MSI (23.8%); MSI-L, 12 cases; MSI-H, 3 cases. MSI was associated with the direct effect to CDDP-based chemotherapy (p<0.05). However, no significant relation of MSI was seen with patient age, tumor stage, histologic grade or presence of ascites. In stage III/IV cases with a postoperative residual tumor with MSI showed significantly poorer postoperative outcomes than those without MSI (p<0.05). Conclusion. MSI in an OSC predicted resistance to CDDP-based chemotherapy, and in advanced OSC, MSI also predicted poor outcome.
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