THE VALUE OF THE EXPRESSION OF K-RAS AND DNA-STATUS IN THE PROGRESSION OF ENDOMETRIOID ENDOMETRIAL CARCINOMA IN PATIENTS WITH EARLY STAGES OF TUMOR PROCESS

Abstract

Summary. Aim: evaluation of DNA ploidy and K-RAS oncoprotein expression in endometrioid endometrial carcinoma (EEC) to determine the metastatic potential of patients with an initial stage of the malignant process. Objects and methods: the study was conducted on samples of postoperative material of 54 patients with EEC stage I according to FIGO (average age: 60.4 years; part from 38 to 72 years). Clinical, morphological, immunohistochemical, flow cytometry, and statistical methods were used for the research. Results: retrospective analysis of medical history revealed patients with EEC who developed metastases in regional lymph nodes within 1.8– 36.6 months. On the basis of this, two groups of studies were formed: I — EEC of patients without metastases (n = 34), II — patients with metastases (n = 20). As a result of the evaluation of the clinical and pathological features of EEC, it was established that G1–G2 tumors predominated (79.4%) in patients of the I group, and in 70.6% of cases, not deep invasion of the myometrium was detected. 55.0% of EEC of the II group had a low degree of differentiation with the deep invasion of the myometrium, which was correlated with a high expression of the oncoprotein K-RAS and the proliferation index. Aneuploidy with iDNA ≥ 2.0 was observed in 20.0% of EEC II group. In such regions, a probably higher expression of K-RAS was determined with this indicator in diploid carcinomas of this group. In addition, the term of occurrence of metastases in patients with aneuploidy was probably shorter than in patients of this group with diploid statuses. Conclusions: it was established that the expression of the K-RAS oncoprotein and DNA ploidy in EEC are associated with the course of the tumor process in stage I patients, which makes it possible to verify patients with a high risk of metastasis.