To better elucidate the role of genetic instability in the development
of gastric cancer, microsatellite alterations were examined in a tota
l of 30 gastric cancers that developed in 14 Japanese patients with mu
ltiple gastric cancers, which are considered to have possibly occurred
under the same genetic background and in the same microenvironment of
the stomach. Microsatellite instability (MSI) in multiple gastric can
cers was recognized in 11 out of 14 cases (78.5%) and in 16 out of 30
cancers (53.3%). Eight out of 11 cases showing MSI exhibited a heterog
eneity of microsatellite alterations. The incidence of microsatellite
instability in the multiple gastric cancers cases was significantly hi
gher than that in the solitary gastric cancer cases reported previousl
y (20.8%: 5 out of 24 cases). These results suggested that (1) genetic
instability plays a more important role in the development of multipl
e gastric cancers than in that of solitary gastric cancer and (2) the
heterogeneity of MSI in multiple gastric cancers may not be a rare eve
nt, although the significance of the heterogeneity could not be clarif
ied. (C) 1995 Wiley-Liss, Inc.