结肠直肠癌的不同瘤特征 代码特异性KRAS突变:不是代码13而是代码12具有预后价值
Hong-Min Ahn1, Duck-Woo Kim2, Hyeon Jeong Oh3
1Department of Surgery, Seoul National University Bundang Hospital, Seongnam 13620, South Korea.
基尔斯大鼠肉瘤病毒瘤基因同源 (KRAS) 编码12突变与较差的结直肠癌结果有关,与编码13突变不同. KRAS编码子12是CRC复发的独立风险因素.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 遗传学 是一个遗传学.
背景情况:
- 大约40%的结肠直肠癌 (CRC) 病例都携带了基尔斯大鼠肉瘤病毒性瘤基因同源 (KRAS) 突变.
- 克拉斯突变,特别是在编码子12处,与CRC预后不佳,转移和生存率降低有关.
- 在CRC中KRAS编码子13突变的临床病理学特征和预后意义尚不清楚.
研究的目的:
- 在结直肠癌中研究子特异性KRAS突变的临床病理特征.
- 与其他KRAS突变相比,评估KRAS编码子13突变的预后价值,特别是编码子12.
主要方法:
- 对2203名经过手术的I-III期CRC患者 (2009-2019) 的回顾性分析.
- 评估KRAS突变状态 (12,13,61编码体) 和与临床病理特征的相关性.
- 考克斯比例危险回归模型用于确定复发相关因素和预后意义.
主要成果:
- 在27.7%,9.1%和1.3%的患者中,分别发现了12号,13号和61号编码子的KRAS突变.
- KRAS编码子12突变与晚期瘤阶段,淋巴结参与,血管入侵,围神经入侵,较大的瘤大小和微卫星不稳定性有关.
- 在多变量分析中,KRAS编码子12突变与较低的5年无复发生存率显著相关,并被确定为复发的独立风险因素.
结论:
- 结直肠癌中KRAS编码子13突变似乎与不良的病理特征或复发无关.
- KRAS编码子12突变与侵略性病理特征有关,是CRC复发的独立预测因子.
- 与KRAS codon 13突变相比,KRAS codon 12突变是结直肠癌的一个更重要的预后生物标志物.
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