KRAS序列变化作为年轻或晚发性结肠直肠癌患者的预后标记
Mayada A Aljehani1, Jeffrey Bien2, Jerry S H Lee1,3,4,5
1Ellison Institute of Technology, Los Angeles, California.
JAMA network open
|November 30, 2023
概括
KRAS序列变异与年轻发病和晚发病结直肠癌 (CRC) 的死亡率增加有关. 对于年轻发病的CRC,KRAS变体与远端瘤的死亡风险高于近端瘤的死亡风险相关.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学是一种遗传学.
- 癌症研究 癌症研究
背景情况:
- KRAS序列变化与结直肠癌 (CRC) 结果之间的关联对于个性化治疗策略至关重要.
- 了解KRAS变异如何根据发病时的年龄和瘤位置影响生存,是CRC研究的一个不断发展的领域.
研究的目的:
- 研究KRAS序列变异,发病时的年龄 (年轻发病与晚发病) 和瘤侧向与结直肠癌特异性存活率 (CSS) 之间的关系.
- 在CRC中描述KRAS变异对不同患者人口统计和瘤特征的死亡风险的影响.
主要方法:
- 一项采用监测,流行病学和最终结果 (SEER) 数据库数据的横截面研究,包括2010年至2015年期间被诊断患有CRC的21,661名患者.
- 使用 Fine 和 Gray 累积发病率,Kaplan-Meier 曲线和竞争风险模型进行生存分析,以估计 KRAS 状态,发病年龄和瘤位置的分发危险比率 (sHR).
- 患者被分为年轻发病 (YO,20-49岁) 和晚发病 (LO,≥50岁) 组.
主要成果:
- KRAS序列变化与YO (3.0与3.5年相比,P=.02) 和LO (2.5与3.4年相比,P<.001) 结直肠癌患者的CSS减少显著相关.
- 在YO (sHR,1.09) 和LO (sHR,1.06) 组中,与野生型KRAS瘤相比,KRAS瘤变异显示了与CRC相关的死亡风险更高.
- 在YO CRC中,与右侧瘤相比,与远端瘤位置 (左侧和直肠) 相比,死亡风险增加,LO CRC中没有观察到这一趋势.
结论:
- 克拉斯序列变异是一种独立的风险因素,与早期和晚期结直肠癌的死亡率增加有关.
- 对于年轻发病的CRC,与KRAS变体相关的死亡风险在远端瘤中更为明显,这表明瘤位置在调节结果中的作用.
- 这些发现强调了考虑KRAS状态,发病年龄和瘤位置在结直肠癌管理中的预后评估和治疗决策的重要性.
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