P21 protein expression and ras-oncogene mutations in gastric carcinoma: correlation with clinical data.

Ras oncogenes coding for P21 protein are frequently involved in the carcinogenesis of various human tumours. For gastric carcinomas, the role of these oncogenes has not yet been fully understood. Forty-five primary gastric carcinomas were investigated for point mutations in the hot spot regions codon 12 and 13 of exon 1 and codon 61 of exon 2 of H-, K- and N-ras gene. PCR-SSCP technique followed by direct sequencing was used. The expression of P21 protein was analysed immunohistochemically. The results were correlated to clinicopathologic data. There were no point mutations in the genes of the ras family. The incidence of P21 protein expression was 66.7% (30 of 45 cases). This expression was more common in carcinomas of the intestinal type than in carcinomas of the diffuse type. There was no correlation with tumour size, metastasis, localisation of the tumour in the stomach, histologic type, grade of malignancy, gender, or clinical outcome of the disease. Overexpression of ras oncoproteins without point mutation seems to occur frequently in gastric carcinoma, particularly in tumours of the intestinal type. There is no prognostic impact. P21 protein expression cannot be used in a predictive staging system.