摘要
目的:探讨结直肠癌组织中KRAS、NRAS及BRAF基因突变状态与临床病理特征的关系。方法:选取接受根治手术治疗的1205例结直肠癌患者的肿瘤组织标本,采用突变扩增阻滞系统检测KRAS、NRAS、BRAF基因的突变状态。1205例患者中,<40岁88例,40~岁663例,≥60岁454例;男722例,女483例;原发于右半结肠244例,左半结肠300例,直肠661例;普通型腺癌1029例,黏液腺癌176例;低分化132例,高/中分化1073例;肿瘤最大径<4 cm者498例,≥4 cm者707例;区域淋巴结转移510例;pTNM分期Ⅰ期212例,Ⅱ期439例,Ⅲ/Ⅳ期554例。结果:1205例结直肠癌组织中共检出KRAS基因突变538例(44.6%),NRAS基因突变33例(2.7%),BRAF基因突变38例(3.2%),不存在交叉突变。KRAS基因突变在黏液腺癌、高/中分化癌组织中的检出率高于普通型腺癌、低分化癌(P<0.05)。不同临床病理特征结直肠癌组织中NRAS基因突变检出率差异无统计学意义(P>0.05),在<40岁的患者中未检出。原发于右半结肠、黏液腺癌、低分化、肿瘤最大径≥4 cm、有淋巴结转移、pTNM分期Ⅲ/Ⅳ期的癌组织中BRAF基因突变检出率更高(P<0.05)。结论:KRAS基因突变与结直肠癌组织学类型和肿瘤分化程度关系密切,BRAF基因突变与多种不良预后相关临床病理特征关系密切。
Aim:To investigate the relationship between KRAS,NRAS and BRAF gene mutations and clinicopathological features in colorectal cancer tissue.Methods:A total of 1205 colorectal cancer patients were enrolled in this study.The mutation status of KRAS,NRAS and BRAF genes was detected using amplification refractory mutation system.Among the 1205 patients,88 patients were<40 years,663 patients were 40-years old,and 454 patients were≥60 years old;722 males and 483 females;primary site were right hemicolon in 244 cases,left hemicolon in 300 cases and rectum in 661 cases;1029 cases were common adenocarcinoma and 176 cases were mucinous adenocarcinoma;132 cases with poor differentiation and 1073 cases with well/moderately differentiation;maximum tumor diameter of 498 patients were<4 cm and that of 707 patients were≥4 cm;510 cases with regional lymph node metastasis;pTNM stageⅠin 212 cases,stageⅡin 439 cases,and stageⅢ/Ⅳin 554 cases.Results:The mutation detection rate of KRAS,NRAS,BRAF gene were 44.6%(538/1205),2.7%(33/1205)and 3.2%(38/1205),respectively.There was no crossover mutation.The mutation detection rate of KRAS gene in mucinous adenocarcinoma was higher than that in non-special type adenocarcinoma(P<0.05),in well/moderately differentiated adenocarcinoma was higher than that in poorly differentiated carcinoma(P<0.05).There was no significant differences in NRAS gene mutation status among the colorectal cancer tissue with different clinicopathological features(P>0.05).The mutation detection rate of BRAF gene was higher in the colorectal cancer tissue with primary site of right colon,mucinous adenocarcinoma,poor differentiation,the largest size of tumor≥4 cm,lymph node metastasis or pTNM stageⅢ/Ⅳ(P<0.05).Conclusion:KRAS gene mutation is associated with histological type and tumor differentiation.BRAF gene mutation is associated with a variety of clinicopathological features indicating poor prognosis.
作者
孙耀华
汪润秋
赵静
李雪莹
杨慧玲
白辰光
SUN Yaohua;WANG Runqiu;ZHAO Jing;LI Xueying;YANG Huiling;BAI Chenguang(Department of Pathology,the First Affiliated Hospital,Naval Military Medical University,Shanghai 200433)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2021年第1期53-57,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
上海卫生计生系统重要薄弱学科建设计划项目(2015ZB0202)
海军军医大学第一附属医院“234”攀峰计划-平台学科夯基项目(2019YPT003)。
