Lin Qi, Jian Mi, Niu Zheng-Chuan, Xu Ping-Ping, Zheng Peng, Xu Jian-Min
Department of General Surgery, Zhongshan Hospital, Fudan University Shanghai, China.
Int J Clin Exp Pathol. 2018 Dec 1;11(12):5981-5991. eCollection 2018.
This study aimed to explore the prognostic impact of and mutations in patients who underwent simultaneous resection for synchronous colorectal liver metastases (SCRLMs) that were initially resectable. Clinicopathological and outcome data of 139 consecutive patients with SCRLMs who underwent resection between July 2003 and July 2013 was collected from our prospectively established SCRLM database. The and genotypes were evaluated in the primary cancer tissues by pyrosequencing. The prognostic value of and status was assessed by Kaplan-Meier and Cox regression analyses. and mutated in 28.8% and 7.2% of the patients with SCRLMs, respectively, but the genotypes did not significantly associate with any clinicopathologic characteristics. By Kaplan-Meier survival analysis, we found mutation was not significantly associated with short overall survival (OS) ( = 0.213), but was significantly correlated with short disease-free survival (DFS) ( = 0.041); mutation was significantly associated with both short OS and DFS ( = 0.001, <0.001, respectively). Multivariate survival analysis showed mutation was an independent negative prognostic factor for DFS ( = 0.005) and mutation was an independent negative prognostic factor for OS and DFS ( = 0.001, <0.001, respectively). and mutation similarly contributed to an adverse prognostic effect in patients who underwent simultaneous resection for SCRLMs that were initially resectable. These findings should suggest the use of and status in current practice as an important determinant for precision surgery for initially resectable SCRLMs.
本研究旨在探讨在最初可切除的同时性结直肠癌肝转移（SCRLMs）患者中进行同步切除时，[具体基因1]和[具体基因2]突变对预后的影响。从我们前瞻性建立的SCRLM数据库中收集了2003年7月至2013年7月期间连续139例接受SCRLMs切除患者的临床病理和结局数据。通过焦磷酸测序在原发性癌组织中评估[具体基因1]和[具体基因2]的基因型。通过Kaplan-Meier和Cox回归分析评估[具体基因1]和[具体基因2]状态的预后价值。在SCRLMs患者中，[具体基因1]和[具体基因2]突变分别发生在28.8%和7.2%的患者中，但这些基因型与任何临床病理特征均无显著相关性。通过Kaplan-Meier生存分析，我们发现[具体基因1]突变与总生存期（OS）缩短无显著相关性（P = 0.213），但与无病生存期（DFS）缩短显著相关（P = 0.041）；[具体基因2]突变与OS和DFS缩短均显著相关（分别为P = 0.001，P < 0.001）。多因素生存分析显示，[具体基因1]突变是DFS的独立负性预后因素（P = 0.005），[具体基因2]突变是OS和DFS的独立负性预后因素（分别为P = 0.001，P < 0.001）。对于最初可切除的SCRLMs患者进行同步切除时，[具体基因1]和[具体基因2]突变同样对不良预后有影响。这些发现提示在当前实践中，将[具体基因1]和[具体基因2]状态作为最初可切除SCRLMs精准手术的重要决定因素。
