A. Immunohistochemistry results for MLH1, MSH2, and MSH6 The top row demonstrates normal nuclear staining for each mismatch repair protein. The bottom row demonstrates absent staining which is consistent with abnormal mismatch repair protein function. B. Representative example of microsatellite instability in endometrial cancer DNA (bottom) compared to matched normal DNA (top) in one of the NCI-recommended microsatellite markers. In this case, there is a shift in the peaks, representing an error in the DNA replication process and contraction of this microsatellite region. C. Methylation specific PCR results. Lane 1 contains the methylated control. For each case, two PCR reactions were performed with primers specific for the methylated MLH1 promoter (loaded on the left) and with primers specific for the unmethylated MLH1 promoter (loaded on the right). Cases 1 and 2 demonstrate tumors with MLH1 silencing due to MLH1 gene promoter methylation, while case 3 represents and case that may be due to an inherited germline MLH1 gene mutation.