Can K-ras codon 12 mutations be used to distinguish benign bile duct proliferations from metastases in the liver? A molecular analysis of 101 liver lesions from 93 patients

Ralph H. Hruban, Patrick D.J. Sturm, Robbert J.C. Slebos, Robb E. Wilentz, Alex R. Musler, Charles J. Yeo, Taylor A. Sohn, Marie Louise F. Van Velthuysen, G. Johan A. Offerhaus

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    28 Scopus citations

    Abstract

    It can be difficult to distinguish benign bile duct proliferations (BDPs) from well-differentiated metastatic peripancreatic adenocarcinomas on histological grounds alone. Most peripancreatic carcinomas harbor activating point mutations in codon 12 of the K-ras oncogene, suggesting that K-ras mutational status may provide a molecular basis for distinguishing BDPs from liver metastases. The ability of tests for mutations in codon 12 of K-ras to make this distinction was examined in a two-part study. In the first part we determined the K-ras mutational status of 56 liver lesions and 48 primary peripancreatic adenocarcinomas obtained from 48 patients. In the second part of this study an additional 45 liver lesions were studied. In the first 48 patients, activating point mutations in codon 12 of K-ras were detected in 28 (61%) of the 46 primary carcinomas, in 8 (100%) of 8 liver metastases, in 2 (6.5%) of 31 BDPs, and in none (0%) of 14 liver granulomas. Three BDPs and two primary carcinomas did not amplify. To further estimate the prevalence of K-ras mutations in BDPs we analyzed an additional series of 45 mostly incidental BDPs for K-ras mutations. Three (6.7%) of these 45 harbored K-ras mutations. These results suggest that K-ras mutations may be useful in distinguishing BDPs from metastases in the liver; however, there is some overlap in the mutational spectra of BDPs and pancreatic carcinomas.

    Original languageEnglish (US)
    Pages (from-to)943-949
    Number of pages7
    JournalAmerican Journal of Pathology
    Volume151
    Issue number4
    StatePublished - Oct 1 1997

    ASJC Scopus subject areas

    • Pathology and Forensic Medicine

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    Hruban, R. H., Sturm, P. D. J., Slebos, R. J. C., Wilentz, R. E., Musler, A. R., Yeo, C. J., Sohn, T. A., Van Velthuysen, M. L. F., & Offerhaus, G. J. A. (1997). Can K-ras codon 12 mutations be used to distinguish benign bile duct proliferations from metastases in the liver? A molecular analysis of 101 liver lesions from 93 patients. American Journal of Pathology, 151(4), 943-949.