FREQUENT OCCURRENCE OF C-KI-RAS GENE-MUTATIONS IN WELL-DIFFERENTIATEDENDOMETRIAL ADENOCARCINOMA SHOWING INFILTRATIVE LOCAL GROWTH WITH FIBROSING STROMAL RESPONSE

The frequency of c-Ki-ras mutation was examined by polymerase chain re action (single-strand conformation polymorphism and direct sequencing analysis) and its association with histological parameters was analyze d in 110 endometrial adenocarcinoma hysterectomy specimens. The c-Ki-r as mutation was detected in 24 cases (22%). It occurred irrespective o f tumor size, stage or histological grade, and was more frequent in tu mors associated with endometrial hyperplasia (11 of 20, 55%) than in t hose without (10 of 73, 14%). In addition, the frequency of the mutati on was significantly higher in tumors showing an infiltrative growth p attern accompanied by a stromal response consisting of edematous fibro us tissue (19 of 58, 33%), than in those which revealed an expansive g rowth pattern without such a stromal reaction (five of 52, 10%). Even among tumors showing the infiltrative growth pattern, the frequency of c-Ki-ras mutation was especially high (48%) in grade I cases in compa rison with grade II or III cases (20% and 19%). Mutational activation of the c-Ki-ras gene may act at two points in the developmental pathwa y of endometrial adenocarcinoma by enhancing evolution of hyperplasia to adenocarcinoma, and by producing an infiltrative growth with a fibr osing stromal response.