Specific Pattern of RAS Oncogene Mutations in Follicular Thyroid Tumors
V. Vasko,
M. Ferrand,
J. Di Cristofaro,
P. Carayon,
J. F. Henry and
C. de Micco
Institut National de la Santé et de la Recherche Médicale U555 (V.V., M.F., J.D.C., P.C., J.F.H., C.d.M.), Department of Endocrine Surgery (J.F.H.), and Laboratory of Pathology (C.d.M.), Faculty of Medicine, Mediterranean University, Marseille, 13385 France; and Hospital for Endocrine Surgery (V.V.), Kiev, 252000 Ukraine
Address all correspondence and requests for reprints to: Dr. Catherine de Micco, Institut National de la Santé et de la Recherche Médicale U555, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France. E-mail: cathy.demicco{at}medecine.univ-mrs.fr.
The prevalence of H-RAS, K-RAS, and N-RAS gene mutations inthyroid tumors according to malignancy and histology is controversial.Differences in methodology and histological classificationsmay explain discrepant results.
To address this issue, we first performed a pooled analysisof 269 mutations garnered from 39 previous studies. Mutationsproved significantly less frequent when detected with directsequencing than without (12.3% vs. 17%). The rate of mutationinvolving N-RAS exon 1 (N1) and K-RAS exon 2 (K2) was less than1%. Mutations of codon 61 of N-RAS (N2) were significantly morefrequent in follicular tumors (19%) than in papillary cancers(5%) and significantly more frequent in malignant (25%) thanin benign (14%) tumors. H-RAS mutations in codons 12/13 (H1)were found in 23% of all types of tumors, but H-RAS mutationsin codon 61 (H2) were observed in only 1.4% of tumors, and almostall of them were malignant. K-RAS mutations in exon 1 were foundmore often in papillary than follicular cancers (2.7% vs. 1.6%)and were sometimes correlated with special epidemiological circumstances.
The second part of this study involved analysis of 80 folliculartumors from patients living in Marseille (France) and Kiev (Ukraine).We used direct sequencing after PCR amplification of exons 1and 2 of the three RAS genes. Common and atypical adenomas wereseparated using strict cytological criteria. Mutations of H1-RASwere found in 12.5% of common adenomas and one follicular carcinoma(2.9%). Mutations of N2-RAS occurred in 23.3% and 17.6% of atypicaladenomas and follicular carcinomas, respectively. These resultsconfirm the predominance of N2-RAS mutations in thyroid folliculartumors and their correlation with malignancy. They support theimplication of N2-RAS mutations in the malignant progressionof thyroid follicular tumors and the assumption that some atypicaladenomas are precursors of follicular carcinomas.
This work was funded by a clinical research contract from MarseillePublic Hospital System.
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