Zhu Kunli, Yan Hongjiang, Wang Renben, Zhu Hui, Meng Xiangjiao, Xu Xiaoqing, Dou Xue, Chen Dong
Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jinan, 250117, China.
Med Oncol. 2014 Jul;31(7):16. doi: 10.1007/s12032-014-0016-6. Epub 2014 May 27.
The objective was to evaluate DNA mutations of KRAS, BRAF, and PIK3CA and their clinicopathological correlations with colorectal cancer (CRC) and to identify their contribution to distant metastases in CRC. A total of 148 tumor samples were obtained from patients with CRC in the Shandong Tumor Hospital and Institute between January 2008 and December 2009. DNA was extracted for polymerase chain reaction amplification and pyrosequencing to evaluate mutations of KRAS, BRAF, and PIK3CA, and clinicopathological correlations of these mutations with CRC [including age, gender, tumor location, pathological type, tumor-node-metastasis (TNM) classification, and distant metastatic status] were analyzed. KRAS, BRAF, and PIK3CA mutation rates were identified in 46 (31.1 %), 11 (7.4 %), and 14 (9.5 %) of the total 148 CRC tumor samples, respectively. Neither mutation had significant correlation with age, gender, size and location of the tumor, and pathological type. KRAS, BRAF, and PIK3CA mutations were found in 14 (66.7 %), 3 (14.3 %), and 8 (38.1 %) of the 21 distant metastatic colorectal tumor samples, respectively. The relative risks of distant metastasis for KRAS, BRAF, and PIK3CA mutations were 30.4 versus 6.8 % (P = 0.001), 27.3 versus 13.1 % (P = 0.191), and 57.1 versus 9.7 % (P < 0.001) (5-year risks), respectively. Patients with either KRAS or PIK3CA mutations are more susceptible to distant metastasis. Thus, these two mutations might be used as independent predictors of distant metastatic CRC.
目的是评估KRAS、BRAF和PIK3CA的DNA突变及其与结直肠癌(CRC)的临床病理相关性,并确定它们在CRC远处转移中的作用。2008年1月至2009年12月期间,从山东省肿瘤医院和研究所的CRC患者中获取了总共148份肿瘤样本。提取DNA用于聚合酶链反应扩增和焦磷酸测序,以评估KRAS、BRAF和PIK3CA的突变,并分析这些突变与CRC的临床病理相关性[包括年龄、性别、肿瘤位置、病理类型、肿瘤-淋巴结-转移(TNM)分类和远处转移状态]。在总共148份CRC肿瘤样本中,KRAS、BRAF和PIK3CA的突变率分别为46(31.1%)、11(7.4%)和14(9.5%)。两种突变均与肿瘤的年龄、性别、大小和位置以及病理类型无显著相关性。在21份远处转移的结直肠肿瘤样本中,分别有14(66.7%)、3(14.3%)和8(38.1%)发现了KRAS、BRAF和PIK3CA突变。KRAS、BRAF和PIK3CA突变远处转移的相对风险分别为30.4%对6.8%(P = 0.001)、27.3%对13.1%(P = 0.191)和57.1%对9.7%(P < 0.001)(5年风险)。KRAS或PIK3CA突变的患者更容易发生远处转移。因此,这两种突变可能用作远处转移CRC的独立预测指标。