KRAS和BRAF突变是接受结直肠癌肺转移瘤切除术患者的预后生物标志物。
KRAS and BRAF mutations are prognostic biomarkers in patients undergoing lung metastasectomy of colorectal cancer.
作者信息
Renaud S, Romain B, Falcoz P-E, Olland A, Santelmo N, Brigand C, Rohr S, Guenot D, Massard G
机构信息
1] Department of Thoracic Surgery, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France [2] EA 3430: Tumoral progression and micro-environment, Translational and epidemiological approaches, Strasbourg University, Strasbourg 67000, France.
1] EA 3430: Tumoral progression and micro-environment, Translational and epidemiological approaches, Strasbourg University, Strasbourg 67000, France [2] Department of General and Digestive Surgery, Hôpital de Hautepierre, Strasbourg University Hospital, Strasbourg 67000, France.
出版信息
Br J Cancer. 2015 Feb 17;112(4):720-8. doi: 10.1038/bjc.2014.499.
BACKGROUND
We evaluated KRAS (mKRAS (mutant KRAS)) and BRAF (mBRAF (mutant BRAF)) mutations to determine their prognostic potential in assessing patients with colorectal cancer (CRC) for lung metastasectomy.
METHODS
Data were reviewed from 180 patients with a diagnosis of CRC who underwent a lung metastasectomy between January 1998 and December 2011.
RESULTS
Molecular analysis revealed mKRAS in 93 patients (51.7%), mBRAF in 19 patients (10.6%). In univariate analyses, overall survival (OS) was influenced by thoracic nodal status (median OS: 98 months for pN-, 27 months for pN+, P<0.0001), multiple thoracic metastases (75 months vs 101 months, P=0.008) or a history of liver metastases (94 months vs 101 months, P=0.04). mBRAF had a significantly worse OS than mKRAS and wild type (WT) (P<0.0001). The 5-year OS was 0% for mBRAF, 44% for mKRAS and 100% for WT, with corresponding median OS of 15, 55 and 98 months, respectively (P<0.0001). In multivariate analysis, WT BRAF (HR: 0.005 (95% CI: 0.001-0.02), P<0.0001) and WT KRAS (HR: 0.04 (95% CI: 0.02-0.1), P<0.0001) had a significant impact on OS.
CONCLUSIONS
mKRAS and mBRAF seem to be prognostic factors in patients with CRC who undergo lung metastasectomy. Further studies are necessary.
背景
我们评估了KRAS（突变型KRAS，即mKRAS）和BRAF（突变型BRAF，即mBRAF）突变，以确定其在评估结直肠癌（CRC）患者行肺转移瘤切除术时的预后潜力。
方法
回顾了1998年1月至2011年12月期间180例诊断为CRC并行肺转移瘤切除术患者的数据。
结果
分子分析显示，93例患者（51.7%）存在mKRAS，19例患者（10.6%）存在mBRAF。单因素分析中，总生存期（OS）受胸段淋巴结状态影响（pN-患者的中位OS为98个月，pN+患者为27个月，P<0.0001）、多发胸段转移（75个月对101个月，P=0.008）或肝转移病史（94个月对101个月，P=0.04）影响。mBRAF患者的OS明显差于mKRAS和野生型（WT）患者（P<0.0001）。mBRAF患者的5年OS为0%，mKRAS患者为44%，WT患者为100%，相应的中位OS分别为15个月、55个月和98个月（P<0.0001）。多因素分析中，野生型BRAF（风险比：0.005（95%置信区间：0.001-0.02），P<0.0001）和野生型KRAS（风险比：0.04（95%置信区间：0.02-0.1），P<0.0001）对OS有显著影响。
结论
mKRAS和mBRAF似乎是接受肺转移瘤切除术的CRC患者的预后因素。有必要进一步研究。
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