Chen Kuo-Hsing, Lin Yu-Lin, Liau Jau-Yu, Tsai Jia-Huei, Tseng Li-Hui, Lin Liang-In, Liang Jin-Tung, Lin Been-Ren, Hung Ji-Shiang, Chang Yih-Leong, Yeh Kun-Huei, Cheng Ann-Lii
Department of Oncology, National Taiwan University Hospital, No 7, Chung-Shan South Rd, Taipei, 10002, Taiwan.
National Taiwan University Cancer Center, Taipei, Taiwan.
Med Oncol. 2016 May;33(5):39. doi: 10.1007/s12032-016-0756-6. Epub 2016 Mar 31.
The prognostic implication of BRAF mutant colorectal cancer remains paradoxical. Records of BRAF mutant and wild-type colorectal cancer patients at all stages were reviewed. Clinicopathologic features, including microsatellite instability, CpG islands methylator phenotype, and overall survival, of these patients were analyzed. Between 2005 and 2013, 428 colorectal cancer patients were enrolled in this study. The overall survival between BRAF mutant and wild-type patients with early-stage (stages I and II) colorectal cancer differed nonsignificantly (P = 0.99). By contrast, in late-stage (stages III and IV) patients, the median overall survival of BRAF mutant patients (N = 25) was significantly poorer than that of BRAF wild-type (N = 207) patients (BRAF mutant: 21.3 months (95% confidence interval [CI] 7.1-35.5); BRAF wild-type: 53.5 months (95% CI 37.5-69.5), P < 0.0001). In early-stage patients, we found that BRAF mutation was significantly associated with CpG island methylator phenotype-positive (P < 0.001), and microsatellite instability-high status (P = 0.0013). Conversely, in late-stage patients, BRAF mutation was significantly associated with CpG island methylator phenotype-positive (P = 0.0015) and the right-side colon (P = 0.014). BRAF mutation may have different prognostic implications in early- and late-stage colorectal cancer.
BRAF 突变型结直肠癌的预后意义仍然存在矛盾。我们回顾了所有分期的 BRAF 突变型和野生型结直肠癌患者的记录。分析了这些患者的临床病理特征，包括微卫星不稳定性、CpG 岛甲基化表型和总生存期。在 2005 年至 2013 年期间，428 例结直肠癌患者纳入本研究。早期（I 期和 II 期）BRAF 突变型和野生型结直肠癌患者的总生存期差异无统计学意义（P = 0.99）。相比之下，在晚期（III 期和 IV 期）患者中，BRAF 突变型患者（N = 25）的中位总生存期明显短于 BRAF 野生型患者（N = 207）（BRAF 突变型：21.3 个月（95%置信区间[CI]7.1 - 35.5）；BRAF 野生型：53.5 个月（95%CI 37.5 - 69.5），P < 0.0001）。在早期患者中，我们发现 BRAF 突变与 CpG 岛甲基化表型阳性（P < 0.001）以及微卫星高度不稳定状态（P = 0.0013）显著相关。相反，在晚期患者中，BRAF 突变与 CpG 岛甲基化表型阳性（P = 0.0015）和右半结肠（P = 0.014）显著相关。BRAF 突变在早期和晚期结直肠癌中可能具有不同的预后意义。
