After multiple cycles of cell division, cells with an impaired MMR system will develop varying lengths in their microsatellite sequences. Impairment of the MMR system can render cells unable to regulate the lengths of their microsatellites during cell division, termed MSI. In normal cells, repeat count of microsatellites is verified and maintained during cell division by the mismatch repair (MMR) system, 2, 3 one of many cellular DNA repair mechanisms. 1 Microsatellites occur at microsatellite loci, which are widely dispersed throughout the human genome. Microsatellites are defined as 10 to 60 base pair regions that contain multiple repeats of 1 to 5 base pair motifs. Large-scale sequencing projects of cancer genomes have opened the door to studies that have identified putative biomarkers with potential clinical and therapeutic value, among them the presence or absence of microsatellite instability (MSI).
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