Orientador: Carmen Sílvia Bertuzzo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T12:57:33Z (GMT). No. of bitstreams: 1 Goncalves_ClaudiaEstela_D.pdf: 2258187 bytes, checksum: 7cac2852cc031e31eba1a31c62d9dda2 (MD5) Previous issue date: 2014 / Resumo: A Anemia de Fanconi (AF) é uma alteração genética caracterizada por múltiplas anomalias congênitas, anormalidades hematológicas e predisposição a uma variedade de tumores. A incidência mundial da AF em todo o mundo é de aproximadamente três por milhão e a frequência de heterozigotos é estimada em um para 300 na Europa e Estados Unidos. É uma doença causada por mutações em genes relacionados ao sistema de reparo. Até o momento foram descritos 16 genes que podem estar multados. São eles: FANCA, FANCB, FANCC, FNCD1, FANCD2, FANCE, FANCF, FANCG, FANCI, FANCJ, FANCL, FANCM, FANCN, FANCO, FANCP E PANCQ. Os grupos mais frequentes são o FANCA e FANCC. De qualquer modo devido a essa heterogeneidade gênica, o diagnóstico molecular dessa alteração é complexo. Com o intuito de testar uma estratégia diagnóstica, o presente trabalho se propôs a identificar as mutações mais frequentes no gene FANC por PCR e digestão enzimática e investigar mutações no gene FANCA, por meio da Reação em Cadeia da Polimerase seguida de digestão enzimática da mutação Brasileira e posterior sequenciamento dos 43 éxons em 60 pacientes portadores de Anemia de Fanconi DEB positivos. Foram detectados 19 pacientes (27,94%), como sendo do grupo C e 16 pacientes como grupo A (23,53%). A mutação ?3788-3790 do gene FANCA teve uma frequência alélica de 15,4%. Foram encontradas 3 mutações intrônicas, 1 mutação sinônima e 1 mutação de sentido trocado no gene FANCA. Não foram encontradas correlações com as manifestações hematológicas, renais, baixo peso, malformações congênitas de membros, machas e pigmentação de pele, sexo e idade / Abstract: The Fanconi Anemia (FA) is a genetic disorder characterized by multiple congenital and hematological abnormalities and predisposition to a variety of tumors. The worldwide incidence of AF is approximately three per million and the frequency of heterozygotes is estimated at one in 300 in Europe and the United States. It is a disease caused by mutations in genes involved in the repair system. So far have been described 16 genes that may be mutated. They are: FANCA , FANCB , FANCC , FNCD1 , FANCD2 , FANCE , FANCF , FANCG , FANCI , FANCJ , FANCL , FANCM , FANCN , FANCO , FANCP And PANCQ . The most common groups are the FANCA and FANCC. However due to this genetic heterogeneity, molecular diagnosis of this change is complex. In order to test a diagnostic strategy, the present study aimed to identify the most frequent mutations in the FANC gene by PCR and restriction enzyme digestion and investigate mutations in the FANCA gene, using the polymerase chain reaction followed by enzymatic digestion of the mutation Brazilian and subsequent sequencing of the 43 exons in 60 patients with Fanconi Anemia positive DEB. 19 patients (27.94%) were detected as group C and 16 patients as group A (23.53%). The ?3788 - 3790 mutation in the FANCA gene had an allelic frequency of 15.4%. Three intronic mutations, one synonymous mutation and one mutation changed direction in FANCA gene were found. No correlation with hematologic, renal, low weight manifestations of congenital malformations members, butches and skin pigmentation, age and sex were found / Doutorado / Clinica Medica / Doutora em Clínica Médica

No description available.

Existe grande interesse na determinação das bases genéticas do carcinoma basocelular (CBC) que expliquem seu fenótipo pouco agressivo e comportamento metastático infreqüente. Investigamos a instabilidade de microssatélites (MSI) e perda de heterozigosidade (LOH) nos microssatélites D6S251 (6q14) e D6S252 (6q16) de CBCs esporádicos de alto e baixo risco histológico através da análise de bandas obtidas pelo gel de poliacrilamida após PCR em comparação com o tecido normal. Não houve alteração do microssatélite D6S252 nas 15 amostras estudadas. Para o microssatélite D6S251, houve alterações em 6 das 26 amostras estudadas (23,07%). MSI e LOH ocorreram em 46,15% das amostras de alto risco (respectivamente 15,38% e 30,76), o que sugere o provável envolvimento da região 6q14 na diferenciação histológica do CBC / A lot of interest lies in determining the genetic basis of basal cell carcinoma (BCC) to explain the lack of aggressive phenotype and infrequent metastatic behavior. We have analyzed the microsatellite instability (MSI) and loss of instability (LOH) in the D6S251 (6q14) and D6S252 (6q16) microsatellites patterns of histological low- high-risk sporadic BCC tumor samples using PCR-based assay in comparison with normal tissue. We have not found any alteration in D6S252 microsatellite 15 samples studied. We have encountered D6S251 alterations in 6 of 26 BCC samples (23.07%).MSI and LOH occurred in 46.15% of high-risk samples (15.38% and 30.76%), These results probably suggests participation of 6q14 region in histological differentiation of BCC

A incidência dos tumores adrenocorticais na região sul do Brasil é 10-15 vezes maior que a incidência mundial. Mutações no gene supressor tumoral p53, localizado na região 17p13.1 têm sido identificadas em diversos tumores humanos. Uma distinta mutação germinativa, Arg337His, localizada no domínio de tetramerização da proteína supressora tumoral P53 foi identificada em 35 de 36 crianças da região sul do Brasil. No presente trabalho, investigamos a presença da mutação Arg337His em 71 pacientes não relacionados, 41 adultos e 30 crianças, portadores de tumores adrenocorticais benignos e malignos. Adicionalmente, análise de perda de heterozigose do locus p53, mapa de deleção do cromossomo 17 e instabilidade cromossômica foram estudados em DNA genômico destes pacientes. Nenhum dos pacientes estudados apresentava histórico familial compatível com a síndrome de Li-Fraumeni. Sequenciamento automático permitiu a identificação da mutação Arg337His, em DNA extraído a partir de sangue periférico e/ou tecido tumoral, em 29 (24 crianças e 5 adultos) dos 71 pacientes. Nas 10 famílias em que foi possível analisar o DNA genômico de ambos os pais verificamos que a mutação Arg337His tem caráter hereditário. Por outro lado, esta mutação não foi encontrada em DNA de 160 indivíduos do grupo controle, não relacionados, analisados por sequenciamento automático e/ou digestão enzimática. A análise pareada de DNA gênomico de sangue periférico e de tecido tumoral revelou perda de heterozigose para o locus p53 em 18 de 21 (86%) pacientes portadores da mutação Arg337His. Não observamos correlação entre a presença desta mutação e o comportamento maligno dos tumores. O estudo de dois marcadores polimórficos intragênicos do p53, pelo programa de análise de tamanho de fragmento GeneScan, evidenciou um mesmo haplótipo associado à mutação Arg337His em 91% dos pacientes com tumores adrenocorticais, configurando uma origem comum para esta mutação. O estudo de 6 marcadores polimórficos ao longo do cromossomo 17 (D17S926, VNTRP53, D17S1856, D17S942, D17S1351 e D17S928) em DNA genômico pareado de 29 pacientes demonstrou uma freqüência elevada (81%) de perda do cromossomo 17 em associação à mutação Arg337His. Não observamos correlação entre a perda do cromossomo 17 e a agressividade tumoral nestes pacientes. Instabilidade cromossômica envolvendo os cromossomos 2, 9 e 11 nos 17 pacientes que perderam o cromossomo 17 foi identificada em 47%, 47% e 71%, respectivamente. Perda dos cromossomos 2 e 11 foi evidenciada em tumores benignos e malignos. A perda do cromossomo 9 foi evidenciada exclusivamente nos tumores malignos, assim como a perda concomitante de 3 ou mais cromossomos. Em conclusão, confirmamos uma freqüência elevada da mutação Arg337His em crianças brasileiras com tumores adrenocorticais benignos e malignos. Esta mutação também foi encontrada no grupo de adultos, embora em menor freqüência. Não houve correlação entre sua presença e o comportamento maligno dos tumores adrenocorticais. Efeito fundador para a mutação Arg337His e inativação bialélica do p53, caracterizada pela presença da mutação Arg337His e a perda do cromossomo 17 foram demonstradas na maioria dos casos analisados. Finalmente, a instabilidade cromossômica envolvendo três ou mais cromossomos contribuiu para o diagnóstico de carcinoma adrenocortical / The incidence of adrenocortical tumors in the South region of Brazil is 10 to 15 times higher than the worldwide one. Mutations in the tumor suppressor p53 gene, located in chromosome 17p13.1, have been described in different human tumors. A germline mutation, Arg337His, in the tetramerization domain of the tumor suppressor P53 was identified in 35 of 36 children from the South region of Brazil. In the present study we have searched for Arg337His mutation in genomic DNA of 71 non-related patients, 41 adults and 30 children, with benign or malignant adrenocortical tumors. Additionally, we also analyzed the loss of heterozigosity of p53 locus, deletion mapping of chromosome 17 and chromosome instability, in genomic DNA of these patients. None of the patients had a familial history of Li-Fraumeni syndrome. Automatic sequencing identified the Arg337His mutation in genomic DNA from peripheral leukocytes and/or tumor tissues in 29 (24 children and 5 adults) of these 71 patients. In 10 families in which the study of both parent\'s DNA was possible, the Arg337His mutation was inherited from one of the parents. Sequencing analysis and/or enzymatic restriction showed that this mutation was not present in DNA of 160 non-related control subjects. Paired analysis of genomic DNA of peripheral leukocytes and tumor tissue revealed loss of heterozigosity of p53 locus in 18/21 (86%) patients with Arg337His mutation. There was no correlation between the presence of this mutation and the malignant behavior of these tumors. The study of two intragenic polymorphic markers of p53 through GeneScan software showed the association of the same haplotype with the Arg337His mutation in 91% of patients with adrenocortical tumors, indicating a common origin of this mutation. The study of 6 polymorphic markers along chromosome 17 (D17S926, VNTRP53, D17S1856, D17S942, D17S1351, D17S928) in paired genomic DNA of 29 patients showed an increased frequency (81%) of chromosome 17 loss in association with the presence of the Arg337His mutation. We did not observe any correlation between the loss of chromosome 17 and aggressive tumor behavior in these patients. In the 17 patients who lost chromosome 17, chromosome instability of chromosomes 2, 9 and 11 was identified in 47%, 47% e 71%, respectively. Loss of chromosomes 2 and 11 was observed in benign and malignant tumors, whereas the loss of chromosome 9 was observed exclusively on malignant tumors. Similarly, the concomitant loss of 3 or more chromosomes was only observed in malignant tumors. In conclusion we confirmed an increased frequency of Arg337His mutation in Brazilian children with benign or malignant adrenocortical tumors. This mutation was also found in the adult group, although at a lower frequency. There was no correlation between the presence of the mutation and the malignant behavior of adrenocortical tumor. We demonstrated a founder effect for this mutation and also a biallelic inactivation of p53 characterized by the presence of the Arg337His mutation and the loss of chromosome 17 in most of the cases studied. Finally, chromosome instability involving 3 or more chromosomes contributed for the diagnosis of adrenocortical carcinoma in these

Objective: Two chromosomal instability (CIN) pathways are described in glioblastoma multiforme (GBM), type 1 and type 2, which can be observed in up to 70% of the cases. Microsatellite instability (MSI) plays a pathogenic role in sporadic cancers such as colon, gastric and endometrial carcinomas with deficient mismatch repair (MMR). We aimed to perform a comprehensive analysis of the relationship between CIN and MSI mechanisms in sporadic glioblastomas. Methods: 129 GBMs were examined (109 newly diagnosed and 20 relapses) investigating MSI, immunohistochemical expression of MMR proteins as well as sequencing and promoter methylation of hMLH1. We characterized the molecular changes frequently correlated with CIN in MSI+ GBMs and compared them with 26 microsatellite-stable tumors. Results: Low-level MSI was observed in 11 of 129 (8.5%) cases and was higher in relapses than in primary GBMs (25 vs. 5.5%, p = 0.027). High-level MSI was not found in any case. A deficient expression of MLH1 and PMS2 without hMLH1 inactivation was observed only in one giant cell GBM. 55% of the MSI+ GBMs showed a profile which did not correspond to one of the known CIN pathways. An inverse association was observed between MSI and mutations of both p53 and PTEN. Conclusions: Our data suggest that CIN and MSI contribute to the genomic instability in GBMs via independent pathways. Since MSI was significantly more frequent in relapses, it might play a role in the malignant progression of GBM. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Diss. (sammanfattning) Umeå : Umeå universitet, 2008. / Härtill 4 uppsatser.

Existe grande interesse na determinação das bases genéticas do carcinoma basocelular (CBC) que expliquem seu fenótipo pouco agressivo e comportamento metastático infreqüente. Investigamos a instabilidade de microssatélites (MSI) e perda de heterozigosidade (LOH) nos microssatélites D6S251 (6q14) e D6S252 (6q16) de CBCs esporádicos de alto e baixo risco histológico através da análise de bandas obtidas pelo gel de poliacrilamida após PCR em comparação com o tecido normal. Não houve alteração do microssatélite D6S252 nas 15 amostras estudadas. Para o microssatélite D6S251, houve alterações em 6 das 26 amostras estudadas (23,07%). MSI e LOH ocorreram em 46,15% das amostras de alto risco (respectivamente 15,38% e 30,76), o que sugere o provável envolvimento da região 6q14 na diferenciação histológica do CBC / A lot of interest lies in determining the genetic basis of basal cell carcinoma (BCC) to explain the lack of aggressive phenotype and infrequent metastatic behavior. We have analyzed the microsatellite instability (MSI) and loss of instability (LOH) in the D6S251 (6q14) and D6S252 (6q16) microsatellites patterns of histological low- high-risk sporadic BCC tumor samples using PCR-based assay in comparison with normal tissue. We have not found any alteration in D6S252 microsatellite 15 samples studied. We have encountered D6S251 alterations in 6 of 26 BCC samples (23.07%).MSI and LOH occurred in 46.15% of high-risk samples (15.38% and 30.76%), These results probably suggests participation of 6q14 region in histological differentiation of BCC

A incidência dos tumores adrenocorticais na região sul do Brasil é 10-15 vezes maior que a incidência mundial. Mutações no gene supressor tumoral p53, localizado na região 17p13.1 têm sido identificadas em diversos tumores humanos. Uma distinta mutação germinativa, Arg337His, localizada no domínio de tetramerização da proteína supressora tumoral P53 foi identificada em 35 de 36 crianças da região sul do Brasil. No presente trabalho, investigamos a presença da mutação Arg337His em 71 pacientes não relacionados, 41 adultos e 30 crianças, portadores de tumores adrenocorticais benignos e malignos. Adicionalmente, análise de perda de heterozigose do locus p53, mapa de deleção do cromossomo 17 e instabilidade cromossômica foram estudados em DNA genômico destes pacientes. Nenhum dos pacientes estudados apresentava histórico familial compatível com a síndrome de Li-Fraumeni. Sequenciamento automático permitiu a identificação da mutação Arg337His, em DNA extraído a partir de sangue periférico e/ou tecido tumoral, em 29 (24 crianças e 5 adultos) dos 71 pacientes. Nas 10 famílias em que foi possível analisar o DNA genômico de ambos os pais verificamos que a mutação Arg337His tem caráter hereditário. Por outro lado, esta mutação não foi encontrada em DNA de 160 indivíduos do grupo controle, não relacionados, analisados por sequenciamento automático e/ou digestão enzimática. A análise pareada de DNA gênomico de sangue periférico e de tecido tumoral revelou perda de heterozigose para o locus p53 em 18 de 21 (86%) pacientes portadores da mutação Arg337His. Não observamos correlação entre a presença desta mutação e o comportamento maligno dos tumores. O estudo de dois marcadores polimórficos intragênicos do p53, pelo programa de análise de tamanho de fragmento GeneScan, evidenciou um mesmo haplótipo associado à mutação Arg337His em 91% dos pacientes com tumores adrenocorticais, configurando uma origem comum para esta mutação. O estudo de 6 marcadores polimórficos ao longo do cromossomo 17 (D17S926, VNTRP53, D17S1856, D17S942, D17S1351 e D17S928) em DNA genômico pareado de 29 pacientes demonstrou uma freqüência elevada (81%) de perda do cromossomo 17 em associação à mutação Arg337His. Não observamos correlação entre a perda do cromossomo 17 e a agressividade tumoral nestes pacientes. Instabilidade cromossômica envolvendo os cromossomos 2, 9 e 11 nos 17 pacientes que perderam o cromossomo 17 foi identificada em 47%, 47% e 71%, respectivamente. Perda dos cromossomos 2 e 11 foi evidenciada em tumores benignos e malignos. A perda do cromossomo 9 foi evidenciada exclusivamente nos tumores malignos, assim como a perda concomitante de 3 ou mais cromossomos. Em conclusão, confirmamos uma freqüência elevada da mutação Arg337His em crianças brasileiras com tumores adrenocorticais benignos e malignos. Esta mutação também foi encontrada no grupo de adultos, embora em menor freqüência. Não houve correlação entre sua presença e o comportamento maligno dos tumores adrenocorticais. Efeito fundador para a mutação Arg337His e inativação bialélica do p53, caracterizada pela presença da mutação Arg337His e a perda do cromossomo 17 foram demonstradas na maioria dos casos analisados. Finalmente, a instabilidade cromossômica envolvendo três ou mais cromossomos contribuiu para o diagnóstico de carcinoma adrenocortical / The incidence of adrenocortical tumors in the South region of Brazil is 10 to 15 times higher than the worldwide one. Mutations in the tumor suppressor p53 gene, located in chromosome 17p13.1, have been described in different human tumors. A germline mutation, Arg337His, in the tetramerization domain of the tumor suppressor P53 was identified in 35 of 36 children from the South region of Brazil. In the present study we have searched for Arg337His mutation in genomic DNA of 71 non-related patients, 41 adults and 30 children, with benign or malignant adrenocortical tumors. Additionally, we also analyzed the loss of heterozigosity of p53 locus, deletion mapping of chromosome 17 and chromosome instability, in genomic DNA of these patients. None of the patients had a familial history of Li-Fraumeni syndrome. Automatic sequencing identified the Arg337His mutation in genomic DNA from peripheral leukocytes and/or tumor tissues in 29 (24 children and 5 adults) of these 71 patients. In 10 families in which the study of both parent\'s DNA was possible, the Arg337His mutation was inherited from one of the parents. Sequencing analysis and/or enzymatic restriction showed that this mutation was not present in DNA of 160 non-related control subjects. Paired analysis of genomic DNA of peripheral leukocytes and tumor tissue revealed loss of heterozigosity of p53 locus in 18/21 (86%) patients with Arg337His mutation. There was no correlation between the presence of this mutation and the malignant behavior of these tumors. The study of two intragenic polymorphic markers of p53 through GeneScan software showed the association of the same haplotype with the Arg337His mutation in 91% of patients with adrenocortical tumors, indicating a common origin of this mutation. The study of 6 polymorphic markers along chromosome 17 (D17S926, VNTRP53, D17S1856, D17S942, D17S1351, D17S928) in paired genomic DNA of 29 patients showed an increased frequency (81%) of chromosome 17 loss in association with the presence of the Arg337His mutation. We did not observe any correlation between the loss of chromosome 17 and aggressive tumor behavior in these patients. In the 17 patients who lost chromosome 17, chromosome instability of chromosomes 2, 9 and 11 was identified in 47%, 47% e 71%, respectively. Loss of chromosomes 2 and 11 was observed in benign and malignant tumors, whereas the loss of chromosome 9 was observed exclusively on malignant tumors. Similarly, the concomitant loss of 3 or more chromosomes was only observed in malignant tumors. In conclusion we confirmed an increased frequency of Arg337His mutation in Brazilian children with benign or malignant adrenocortical tumors. This mutation was also found in the adult group, although at a lower frequency. There was no correlation between the presence of the mutation and the malignant behavior of adrenocortical tumor. We demonstrated a founder effect for this mutation and also a biallelic inactivation of p53 characterized by the presence of the Arg337His mutation and the loss of chromosome 17 in most of the cases studied. Finally, chromosome instability involving 3 or more chromosomes contributed for the diagnosis of adrenocortical carcinoma in these

TIF1γ est une protéine nucléaire de 1127 acides aminés possédant deux activités : une activité d'E3-ubiquitine ligase et des fonctions de régulateur transcriptionnel. TIF1γ exerce majoritairement ses fonctions dans les processus de développement embryonnaire et de différenciation cellulaire, notamment via son implication dans la voie de signalisation du TGFβ. Le rôle anti-tumoral de TIF1γ a été mis en évidence dans plusieurs modèles murins et son expression est diminuée dans de nombreuses tumeurs humaines de diverses origines tissulaires. Néanmoins, les mécanismes moléculaires et cellulaires par lesquels TIF1γ exerce ses fonctions oncosuppressives sont méconnus. Dans ces travaux, nous avons pu mettre en évidence le rôle inhibiteur de TIF1γ sur la transition épithélio-mésenchymateuse (EMT, Epithelial-to- Mesenchymal Transition) médiée par le TGFβ in vivo, permettant ainsi de limiter les propriétés agressives des cellules tumorales. De plus, nous avons décrit l'implication de TIF1γ dans la progression de la mitose et le point de contrôle du fuseau mitotique : les cellules n'exprimant plus TIF1γ présentent de nombreuses anomalies nucléaires ainsi qu'une forte aneuploïdie associée à une résistance aux agents ciblant les microtubules, molécules classiquement utilisées en chimiothérapie. De plus, nous avons pu corréler la faible expression de TIF1γ à une augmentation de l'instabilité chromosomique dans différentes tumeurs humaines. Ainsi, nos travaux ont permis de mettre en évidence le phénotype cellulaire induit par la perte de TIF1γ dans les cellules tumorales : instabilité chromosomique, résistance aux traitements chimiothérapeutiques et acquisition de propriétés invasives / TIF1γ / TRIM33 (Transcriptional Intermediary Factor 1γ / TRIpartite Motif-containing 33) is a 1,127 amino acids nuclear protein with two biochemical activities: an E3-ubiquitin ligase activity and transcriptional regulatory functions. TIF1γ is ubiquitously expressed in many organisms and exerts its functions mainly in the processes of embryonic development and cell differentiation, particularly through its involvement in the TGFβ signaling pathway. The oncosuppressive functions of TIF1γ have been demonstrated in several mouse models and its expression is reduced in many human tumors of various tissue origins. Nevertheless, the molecular and cellular mechanisms driving TIF1γ anti-tumoral activities are unknown. In this work, we highlight its inhibitory role on TGFβ-mediated EMT (Epithelial-to-Mesenchymal Transition) in vivo, thus limiting the aggressive properties of tumor cells. In addition, we describe TIF1γ involvement in mitotic progression and the Spindle Assembly Checkpoint (SAC): TIF1γ deleted cells display many nuclear abnormalities, aneuploidy and resistance to spindle microtubule-disrupting agents, which are drugs classically used in chemotherapeutic treatments. Finally, we correlated the low expression level of TIF1γ to an increased rate of chromosomal instability in different human tumors. Thus, our work has highlighted the tumor suppressor role of TIF1γ: its deletion in tumor cells induce chromosomal instability, resistance to chemotherapeutic treatments and acquisition of invasive properties

Objective: Two chromosomal instability (CIN) pathways are described in glioblastoma multiforme (GBM), type 1 and type 2, which can be observed in up to 70% of the cases. Microsatellite instability (MSI) plays a pathogenic role in sporadic cancers such as colon, gastric and endometrial carcinomas with deficient mismatch repair (MMR). We aimed to perform a comprehensive analysis of the relationship between CIN and MSI mechanisms in sporadic glioblastomas. Methods: 129 GBMs were examined (109 newly diagnosed and 20 relapses) investigating MSI, immunohistochemical expression of MMR proteins as well as sequencing and promoter methylation of hMLH1. We characterized the molecular changes frequently correlated with CIN in MSI+ GBMs and compared them with 26 microsatellite-stable tumors. Results: Low-level MSI was observed in 11 of 129 (8.5%) cases and was higher in relapses than in primary GBMs (25 vs. 5.5%, p = 0.027). High-level MSI was not found in any case. A deficient expression of MLH1 and PMS2 without hMLH1 inactivation was observed only in one giant cell GBM. 55% of the MSI+ GBMs showed a profile which did not correspond to one of the known CIN pathways. An inverse association was observed between MSI and mutations of both p53 and PTEN. Conclusions: Our data suggest that CIN and MSI contribute to the genomic instability in GBMs via independent pathways. Since MSI was significantly more frequent in relapses, it might play a role in the malignant progression of GBM. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.