[Detection of K-ras oncogene activation in human lung cancer and its possible clinical application]

By using a modified polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) technique, we detected K-ras codon 12 mutation in 102 formalin-fixed, paraffin-embedded tissues from surgical samples of lung cancer patients. The X2 test was used to determine the statistical significance of difference, according to the presence or absence of mutation in codon 12 of K-ras oncogene. We found 25 cases (24%) positive for mutation of K-ras 12 codon. Mutation occurred in 6 of the 40 cases (15%) of squamous cell carcinoma, 18 of 37 adenocarcinoma cases (49%), 1 of 2 adenosquamous cases, 0 of 1 carcinoid patient, but no K-ras activation was found in small cell carcinoma (0/22) cases. Analysis of the clinical and pathological features of 37 adenocarcinoma cases showed no apparent associations between the K-ras codon 12 mutation and sex, disease stage, tumor size (T), metastatic status (M) and the degree of differentiation (all P values greater than 0.05), but the nodes (N) of K-ras-positive adenocarcinoma tended to be more than the K-ras-negative ones (P < 0.01). From 26 male cases of adenocarcinoma mutation in codon 12 of K-ras occur more frequently in adenocarcinoma from smokers than non-smokers (P < 0.05), suggesting that smoking is an important factor in the induction of the mutation. Among 37 adenocarcinoma cases, only 25 cases can be traced the recurrence rate in 1-year. The 1-year recurrence rates were 85% (11/13) in K-ras mutational patients, more than 25% (3/12) in K-ras negative ones (P < 0.01), whereas there was no relationship between recurrence and differentiation in these 25 cases. The findings suggest the K-ras gene mutation may be one of the prognostic markers for human lung adenocarcinoma.