INTRATUMOR HETEROGENEITY OF K-RAS2 MUTATIONS IN COLORECTAL ADENOCARCINOMAS

Detailed information about intratumor K-ras2 mutations in colorectal a denocarcinomas and a possible association with DNA content heterogenei ty is still lacking. DNA diploid and aneuploid subclones, detected amo ng multiple histologically selected primary sectors (57 superficial an d 40 deep) and 9 lymph node metastases, were flow cytometrically sorte d and separately submitted to codons 12-13 K-ras2 mutation spectrum an alysis. DNA aneuploidy was absent among 20 near and 20 distant mucosa sites and present in 7/9 lymph node metastases and in 17/19 primary tu mors (90%). Primary intratumor DNA multiclonality was approximately 50 %. Degree of DNA aneuploidy (DNA Index) distribution was nonrandom and showed peaks at approximate mean DNA index values of 1.2, 1.5, and 1. 8. K-ras2 mutations were detected in 0/20 mucosa cases, in 2/9 lymph n ode metastases, and in 9/19 adenocarcinomas (47%). No more than one mu tation type per tumor was detected. Intratumor distribution of K-ras2 mutations was homogeneous in 6 and heterogeneous in 3 cases. Homogeneo us distribution was associated with DNA near-diploid aneuploidy. K-ras 2 mutations were strongly associated with DNA Index in the near-diploi d region (83%) and almost absent (5%) among DNA near-triploid subclone s (P = 0.0001). K-ras2 mutation intratumor heterogeneity indicates tha t sampling of the tumor may be a critical step and suggests that K-ras 2 activation may be a late event in a subgroup of tumors. Our data als o suggest the existence of an early process of the colorectal carcinog enesis that favors both K-ras2 mutations and DNA near-diploid aneuploi dy. Onset of DNA near-triploid subclones appears, instead, to be indep endent from K-ras2 activation.