FREQUENT SOMATIC MUTATIONS OF THE APC AND P53 GENES IN SPORADIC AMPULLARY CARCINOMAS

Although a close relation of somatic mutations of the adenomatous poly posis coli gene with ampullary carcinomas in familial adenomatous poly posis patients has been reported, the possible association with sporad ic ampullary neoplasms has not been fully examined. We have therefore investigated loss of heterozygosity at the adenomatous polyposis coli locus and the mutational status of a portion of the adenomatous polypo sis coli gene, including the mutation cluster region, in 17 ampullary carcinomas of non-familial adenomatous polyposis patients. Alteration of the adenomatous polyposis coli gene was found in 8 of 17 (47.1%) ca ses, as missense or insertion mutations, with or without loss of heter ozygosity. Additional investigation of p53 (exons 5-8) and K-ras (codo ns 12 and 13) gene mutations revealed a striking mutational pattern of the p53 gene. Nine of the 17 cases demonstrated a total of 12 mutatio ns, 6 clustered at codon 189 and 3 at codon 166. Furthermore, 5 of the 12 mutations were nonsense mutations. Regarding the K-ras gene, 4 of the 17 (23.5%) cases had mutations In codon 12, 3 of the 4 cases being derived from the intraduodenal bile duct. The findings indicate that alterations of the adenomatous polyposis coli and the p53 genes are re latively frequent in sporadic ampullary carcinomas. In particular, the clustering at specific p53 codons might offer an etiological clue to clarify ampullary carcinogenesis. Mutations of the K-ras gene, on the other hand, might be characteristic of intraduodenal bile duct origin.