Huang Wen-Chih, Tsai Chien-Chen, Chan Chih-Chieh
Department of Anatomic Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan; College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Department of Anatomic Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
J Formos Med Assoc. 2017 Jun;116(6):464-468. doi: 10.1016/j.jfma.2016.07.015. Epub 2016 Oct 10.
BACKGROUND/PURPOSE: Cholangiocarcinoma (CC) is a fatal malignancy originating from biliary tracts and constitutes approximately 10-20% of hepatobiliary cancers. CC is characterized by a very poor prognosis. The definite molecular mechanisms leading to oncogenesis remain unclear. This study aimed to perform mutation analysis and copy number changes of KRAS and BRAF genes of CC in Taiwan.
A total of 182 cases of biliary tact CC were studied for point mutation and quantitative real-time polymerase chain reaction analysis of KRAS and BRAF genes. The obtained data were analyzed with clinical and histopathological variables and survival.
KRAS point mutations were detected in intrahepatic CC (7.6%), common bile duct cancer (13.3%), and gallbladder carcinoma (3.3%). BRAF gene amplifications were demonstrated in intrahepatic CC (4.3%), common bile duct cancer (3.3%), and gallbladder cancer (5%). No association was observed between mutation patterns and histopathological features. The analyses of risk factors for overall survival in patients with CC revealed no significant association in age, tumor site, genetic mutation, or amplifications. The tumor stage was the significant prognostic factor.
Unlike other studies from American, European, or Japanese groups which showed certain levels of gene mutations in CC, our data revealed a rather low frequency of KRAS mutations and BRAF gene amplifications in CC in Taiwan. Tumor TNM stage was the only significant prognostic parameter in this analysis. It is crucial to gain more information of carcinogenesis, molecular mechanisms and therapeutic strategy in biliary tract cholangiocarcinoma.
背景/目的:胆管癌(CC)是一种起源于胆管的致命恶性肿瘤,约占肝胆癌的10%-20%。CC的预后很差。导致肿瘤发生的确切分子机制尚不清楚。本研究旨在对台湾地区CC患者的KRAS和BRAF基因进行突变分析及拷贝数变化研究。
共对182例胆管CC患者进行KRAS和BRAF基因的点突变及定量实时聚合酶链反应分析。将所得数据与临床和组织病理学变量及生存率进行分析。
在肝内CC(7.6%)、胆总管癌(13.3%)和胆囊癌(3.3%)中检测到KRAS点突变。在肝内CC(4.3%)、胆总管癌(3.3%)和胆囊癌(5%)中发现BRAF基因扩增。未观察到突变模式与组织病理学特征之间的关联。对CC患者总生存危险因素的分析显示,年龄、肿瘤部位、基因突变或扩增均无显著关联。肿瘤分期是重要的预后因素。
与美国、欧洲或日本团队的其他研究显示CC存在一定水平的基因突变不同,我们的数据显示台湾地区CC患者中KRAS突变和BRAF基因扩增的频率较低。肿瘤TNM分期是本分析中唯一重要的预后参数。获取更多关于胆管癌发生、分子机制和治疗策略的信息至关重要。