Herreros-Villanueva Marta, Chen Chih-Chieh, Yuan Shyng-Shiou F, Liu Ta-Chih, Er Tze-Kiong
Department of Gastroenterology, Hospital Donostia/Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco UPV/EHU, San Sebastián, Spain.
Center for Lipid Biosciences, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan.
Clin Chim Acta. 2014 Apr 20;431:211-20. doi: 10.1016/j.cca.2014.01.049. Epub 2014 Feb 15.
Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer death globally. Significant improvements in survival have been made in patients with metastasis by new therapies. For example, Cetuximab and Panitumumab are monoclonal antibodies that inhibit the epidermal growth receptor (EGFR). KRAS mutations in codon 12 and 13 are the recognized biomarkers that are analyzed in clinics before the administration of anti-EGFR therapy. Genetic analyses have revealed that mutations in KRAS predict a lack of response to Panitumumab and Cetuximab in patients with metastatic CRC (mCRC). Notably, it is estimated that 35-45% of CRC patients harbor KRAS mutations. Therefore, KRAS mutation testing should be performed in all individuals with the advanced CRC in order to identify the patients who will not respond to the monoclonal EGFR antibody inhibitors. New techniques for KRAS testing have arisen rapidly, and each technique has advantages and disadvantages. Herein, we review the latest published literature specific to KRAS mutation testing techniques. Since reliability and feasibility are important issues in clinical analyses. Therefore, this review also summarizes the effectiveness and limitations of numerous KRAS mutation testing techniques.
结直肠癌（CRC）是全球第三大常见癌症，也是癌症死亡的第二大常见原因。新疗法已使转移性患者的生存率有了显著提高。例如，西妥昔单抗和帕尼单抗是抑制表皮生长因子受体（EGFR）的单克隆抗体。第12和13密码子中的KRAS突变是公认的生物标志物，在临床中抗EGFR治疗前进行分析。基因分析显示，KRAS突变预示着转移性结直肠癌（mCRC）患者对帕尼单抗和西妥昔单抗无反应。值得注意的是，估计35%-45%的CRC患者存在KRAS突变。因此，所有晚期CRC患者均应进行KRAS突变检测，以识别对单克隆EGFR抗体抑制剂无反应的患者。KRAS检测的新技术迅速涌现，每种技术都有优缺点。在此，我们回顾了最新发表的关于KRAS突变检测技术的文献。由于可靠性和可行性是临床分析中的重要问题。因此，本综述还总结了众多KRAS突变检测技术的有效性和局限性。
