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- W2079530127 abstract "Colorectal cancer (CRC) that demonstrates microsatellite instability (MSI) is caused by either germline mismatch repair (MMR) gene mutations, or ‘sporadic’ somatic tumour <i>MLH1</i> promoter methylation. <i>MLH1</i> promoter methylation is reportedly correlated with tumour <i>BRAF</i> V600E mutation status. No systematic review has been undertaken to assess the value of <i>BRAF</i> V600E mutation and <i>MLH1</i> promoter methylation tumour markers as negative predictors of germline MMR mutation status. A literature review of CRC cohorts tested for MMR mutations, and tumour <i>BRAF</i> V600E mutation and/or <i>MLH1</i> promoter methylation was conducted using PubMed. Studies were assessed for tumour features, stratified by tumour MMR status based on immunohistochemistry or MSI where possible. Pooled frequencies and 95% CIs were calculated using a random effects model. <i>BRAF</i> V600E results for 4562 tumours from 35 studies, and <i>MLH1</i> promoter methylation results for 2975 tumours from 43 studies, were assessed. In 550 MMR mutation carriers, the <i>BRAF</i> V600E mutation frequency was 1.40% (95% CI 0.06% to 3%). In MMR mutation-negative cases, the <i>BRAF</i> V600E mutation frequency was 5.00% (95% CI 4% to 7%) in 1623 microsatellite stable (MSS) cases and 63.50% (95% CI 47% to 79%) in 332 cases demonstrating <i>MLH1</i> methylation or MLH1 expression loss. <i>MLH1</i> promoter methylation of the ‘A region’ was reported more frequently than the ‘C region’ in MSS CRCs (17% vs 0.06%, p<0.0001) and in <i>MLH1</i> mutation carriers (42% vs 6%, p<0.0001), but not in MMR mutation-negative MSI-H CRCs (40% vs 47%, p=0.12). Methylation of the ‘C region’ was a predictor of MMR mutation-negative status in MSI-H CRC cases (47% vs 6% in MLH1 mutation carriers, p<0.0001). This review demonstrates that tumour <i>BRAF</i> V600E mutation, and <i>MLH1</i> promoter ‘C region’ methylation specifically, are strong predictors of negative MMR mutation status. It is important to incorporate these features in multifactorial models aimed at predicting MMR mutation status." @default.
- W2079530127 created "2016-06-24" @default.
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- W2079530127 date "2012-02-24" @default.
- W2079530127 modified "2023-10-16" @default.
- W2079530127 title "Correlation of tumour BRAF mutations and<i>MLH1</i>methylation with germline mismatch repair (MMR) gene mutation status: a literature review assessing utility of tumour features for MMR variant classification" @default.
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- W2079530127 doi "https://doi.org/10.1136/jmedgenet-2011-100714" @default.
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