Jang Min Hye, Kim Sehun, Hwang Dae Yong, Kim Wook Youn, Lim So Dug, Kim Wan Seop, Hwang Tea Sook, Han Hye Seung
Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2017 Jan;32(1):38-46. doi: 10.3346/jkms.2017.32.1.38.
In patients with colorectal cancer (CRC), the BRAF V600E mutation has been reported to be associated with several clinicopathological features and poor survival. However, the prognostic implications of BRAF V600E mutation and the associated clinicopathological characteristics in CRCs remain controversial. Therefore, we reviewed various clinicopathological features, including BRAF status, in 349 primary CRCs and analyzed the relationship between BRAF status and various clinicopathological factors, including overall survival. Similar to previous studies conducted in Eastern countries, the incidence of the BRAF V600E mutation in the current study was relatively low (5.7%). BRAF-mutated CRC exhibits distinct clinicopathological features from wild-type BRAF-expressing cancer independent of the microsatellite instability (MSI) status. This mutation was significantly associated with a proximal tumor location (P = 0.002); mucinous, signet ring cell, and serrated tumor components (P < 0.001, P = 0.003, and P = 0.008, respectively); lymphovascular invasion (P = 0.004); a peritumoral lymphoid reaction (P = 0.009); tumor budding (P = 0.046); and peritoneal seeding (P = 0.012). In conclusion, the incidence of the BRAF V600E mutation was relatively low in this study. BRAF-mutated CRCs exhibited some clinicopathological features which were also frequently observed in MSI-H CRCs, such as a proximal location; mucinous, signet ring cell, and serrated components; and marked peritumoral lymphoid reactions.
在结直肠癌(CRC)患者中,据报道BRAF V600E突变与多种临床病理特征及较差的生存率相关。然而,BRAF V600E突变在结直肠癌中的预后意义以及相关的临床病理特征仍存在争议。因此,我们回顾了349例原发性结直肠癌的各种临床病理特征,包括BRAF状态,并分析了BRAF状态与各种临床病理因素(包括总生存期)之间的关系。与之前在东方国家进行的研究相似,本研究中BRAF V600E突变的发生率相对较低(5.7%)。BRAF突变的结直肠癌表现出与野生型BRAF表达的癌症不同的临床病理特征,与微卫星不稳定性(MSI)状态无关。这种突变与肿瘤近端位置显著相关(P = 0.002);黏液性、印戒细胞和锯齿状肿瘤成分(分别为P < 0.001、P = 0.003和P = 0.008);淋巴管浸润(P = 0.004);肿瘤周围淋巴样反应(P = 0.009);肿瘤芽生(P = 0.046);以及腹膜种植(P = 0.012)。总之,本研究中BRAF V600E突变的发生率相对较低。BRAF突变的结直肠癌表现出一些在MSI-H结直肠癌中也经常观察到的临床病理特征,如近端位置;黏液性、印戒细胞和锯齿状成分;以及明显的肿瘤周围淋巴样反应。