Zahir Shokouh Taghipour, NazemianYazdi Mohammadreza, Arasteh Peyman, Mortazavizadeh Mohammadreza, Karbalaeian Mohammad, ZareMehrjardi Malihe
Shokouh Taghipour Zahir, Pathology department, Shahid Sadoughi University of medical sciences, Yazd, Iran Email :
Asian Pac J Cancer Prev. 2016;17(7):3417-22.
By some estimates, colorectal carcinoma is the third most common cancer worldwide. The most appropriate method of treatment, especially of its metastatic form, is determined based on KRAS status. The present study was conducted on patients with colorectal cancer positive or neagtive for a KRAS mutation in terms of survival rate and the response to treatment.
Medical records of all cases with colorectal cancer hospitalized from 2010 to 2015 and with KRAS testing results were studied. Data such as gender, age, tumor (size, grade, location, stage), treatment type, KRAS status and survival were considered as variables. Survival analysis was performed using the KaplanMeier method and Logrank test. Statistical significance level was defined as P value <0.05.
Out of 90 patients, 55 (61.2%) were male and 35(38.8%) were female with the age range of 2287 years. The overall disease specific survival was 53±3 (Mean ± SE) months with 95%CI:4760, and there were statistically significant differences between the mean survival rate with tumor stage and the response to treatment (log rank test, PV=0.007 and PV=0.001) respectively. The risk of mortality was 2.02 times higher in patients with mutant KRAS compared to those with the wild type of the gene; however, this difference was not statistically significant (OR=2.016; 95%CI: 0.685.9; PV=0.197).
In our study the overall 5year disease specific survival rate was low as compared to similar studies elsewhere. Significant correlations were found between survival time with treatment type and tumor stage.
据一些估计，结直肠癌是全球第三大常见癌症。治疗的最合适方法，尤其是转移性结直肠癌的治疗方法，是根据KRAS状态来确定的。本研究针对KRAS突变呈阳性或阴性的结直肠癌患者的生存率和治疗反应展开。
研究了2010年至2015年住院的所有结直肠癌病例的医疗记录以及KRAS检测结果。将性别、年龄、肿瘤（大小、分级、位置、分期）、治疗类型、KRAS状态和生存率等数据视为变量。使用Kaplan-Meier方法和对数秩检验进行生存分析。统计学显著性水平定义为P值<0.05。
90例患者中，男性55例（61.2%），女性35例（38.8%），年龄范围为22至87岁。总体疾病特异性生存率为53±3（均值±标准误）个月，95%置信区间为47至60，肿瘤分期的平均生存率与治疗反应之间分别存在统计学显著差异（对数秩检验，PV = 0.007和PV = 0.001）。KRAS突变患者的死亡风险比野生型基因患者高2.02倍；然而，这种差异无统计学显著性（OR = 2.016；95%置信区间：0.68至5.9；PV = 0.197）。
在我们的研究中，与其他地方的类似研究相比，总体5年疾病特异性生存率较低。发现生存时间与治疗类型和肿瘤分期之间存在显著相关性。
