Hepatic
angiosarcoma (HA) is an uncommon
neoplasm associated with known etiologic factors in 25% to 42% of cases. It is, however, one of the most common
sarcomas found in the liver. The aim of this study was to find was to find mutations in the K-ras-2 oncogene in sporadic and
Thorotrast (TT)-induced HA. Point mutations in K-ras-2 were sought in archival,
formalin-fixed tissue blocks from 24 patients with
angiosarcoma. Of these, 19 cases were sporadic and 5 were TT-induced. Mutational analysis was performed by topographic microdissection with PCR amplification followed by genotyping. Specific mutations were determined by two independent methods: (a) direct sequencing of the PCR product confirmed by rePCR and by using a different sequencing primer, and (b) PCR-based selective enrichment of mutant
DNA by
endonuclease digestion followed by
heteroduplex DNA analysis using denaturing gradient gel electrophoresis. Eleven K-ras-2 point mutations were detected in 7 of 24 (29%)
tumors, including 5 of 19 (26%) sporadic HA and 2 of 5 (40%) TT-induced HA. There were seven G:C > A:T and four G:C > T:A mutations. All seven mutated
tumors contained a
codon 12-aspartate amino acid substitution. In addition, a second
codon 12-cysteine mutant cell population was present in one of two
codon 12-aspartate mutated TT-induced HA and in three of five
codon 12-aspartate sporadic
tumors. Of these four
tumors, three contained both
aspartate and
cysteine mutations and were composed of multiple nodules; the fourth was a single mass. Seventeen
tumors had multiple nodules; whereas 5 had a K-ras-2 mutation, 12 were wild-type. The molecular pathology of both sporadic and TT-induced HA is characterized by a high rate of K-ras-2 mutations characteristic of oxidative damage (ie, G:C > A:T and G:C > T:A mutations) resulting in two mutated population sets:
codon 12 GGT >
GAT and GGT > TGT (
glycine to
aspartic acid and
cysteine). This is, to date, the first study to characterize the K-ras-2 gene mutations within human sporadic and TT-induced HA by direct sequence analysis and denaturing gradient gel electrophoresis. These data further support the hypothesis linking adduct-forming
vinyl chloride exposure to HA containing a much higher frequency of K-ras-2 mutations and a mutational spectrum characteristic of
chloroethylene oxide, a carcinogenic metabolite of
vinyl chloride.