Chang Yu-Yao, Lin Jen-Kou, Lin Tzu-Chen, Chen Wei-Shone, Jeng Kai-Jiang, Yang Shung-Haur, Wang Huann-Sheng, Lan Yuan-Tzu, Lin Chun-Chi, Liang Wen-Yih, Chang Shih-Ching
Hepatogastroenterology. 2014 Oct;61(135):1946-53.
BACKGROUND/AIMS: KRAS mutation is present in 30%-50% of colorectal cancers and is associated with the inefficacy of anti-epidermal growth factor receptor therapy, while the impact of KRAS on survival is seldom discussed. The aim of this study was to elucidate the impact of KRAS status on the survival of patients with metastatic colorectal cancer.
Two hundred and one patients with metastatic colorectal cancer were enrolled. Amplification and sequencing of the KRAS gene were performed, with the overall survival according to KRAS status analyzed.
KRAS mutations were present in 72 (35.8%) of patients, including 55 (27.3%) codon 12 mutations and 17 (8.5%) codon 13 mutations. Lymphovascular invasion (hazard ratio 1.841, 95% confidence interval 1.043-3.247, p = 0.035) and KRAS mutation (hazard ratio 1.919, 95% confidence interval 1.104-3.333, p = 0.021) were independent prognostic factors for overall survival. The median overall survival for patients with KRAS mutation at codon 12 was 27.3 months, and was similar to those with KRAS mutation at codon 13 (20.4 months, p = 0.628).
KRAS mutation is a poor prognostic factor in patients with metastatic colorectal cancer. In KRAS mutation metastatic colorectal cancer, mutation at codon 12 or at codon 13 had no relationship with prognosis.
背景/目的：KRAS 突变存在于 30%-50%的结直肠癌中，与抗表皮生长因子受体治疗无效相关，而 KRAS 对生存的影响鲜有讨论。本研究的目的是阐明 KRAS 状态对转移性结直肠癌患者生存的影响。
纳入 201 例转移性结直肠癌患者。对 KRAS 基因进行扩增和测序，并分析根据 KRAS 状态的总生存期。
72 例（35.8%）患者存在 KRAS 突变，其中 55 例（27.3%）为密码子 12 突变，17 例（8.5%）为密码子 13 突变。淋巴管浸润（风险比 1.841，95%置信区间 1.043-3.247，p = 0.035）和 KRAS 突变（风险比 1.919，95%置信区间 1.104-3.333，p = 0.021）是总生存期的独立预后因素。密码子 12 发生 KRAS 突变的患者中位总生存期为 27.3 个月，与密码子 13 发生 KRAS 突变的患者相似（20.4 个月，p = 0.628）。
KRAS 突变是转移性结直肠癌患者的不良预后因素。在 KRAS 突变的转移性结直肠癌中，密码子 12 或密码子 13 的突变与预后无关。
