Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
Anticancer Res. 2023 Apr;43(4):1563-1568. doi: 10.21873/anticanres.16306.
BACKGROUND/AIM: The clinical significance of many RAS-family mutations in colorectal cancer (CRC) remains unclear. The purpose of this study was to investigate the relationship of RAS mutations on an exon basis (i.e., mutations in KRAS exons 2, 3, and 4 and in NRAS) with clinicopathological features and prognosis in CRC.
We performed a retrospective cohort study of the medical records and frozen tissue samples of 268 consecutive patients with stage I-III CRC who underwent curative resection at a single institution between 2014 and 2018.
The RAS mutation rate was significantly associated with age and histology. Patients with KRAS exon 2 mutations exhibited shorter recurrence-free survival compared to those with KRAS wild-type, KRAS exon 3 mutations, KRAS exon 4 mutations, and NRAS mutations (73.0% vs. 85.5%, 86.7%, 85.7%; p=0.031). Age and histology were independent risk factors for RAS mutations. RAS mutations were independent prognostic factors with respect to recurrence-free survival in patients with stage I-III CRC.
In stage I-III CRC patients, KRAS exon 2 mutations had the worst prognosis, whereas KRAS wild type, exon 3 mutations, exon 4 mutations, and NRAS mutations had better prognoses.
背景/目的：结直肠癌（CRC）中许多 RAS 家族突变的临床意义仍不清楚。本研究旨在探讨基于外显子的 RAS 突变（即 KRAS 外显子 2、3 和 4 以及 NRAS 中的突变）与 CRC 的临床病理特征和预后的关系。
我们对 2014 年至 2018 年在一家机构接受根治性切除术的 268 例 I-III 期 CRC 连续患者的病历和冷冻组织样本进行了回顾性队列研究。
RAS 突变率与年龄和组织学显著相关。与 KRAS 野生型、KRAS 外显子 3 突变、KRAS 外显子 4 突变和 NRAS 突变相比，KRAS 外显子 2 突变患者的无复发生存率更短（73.0% vs. 85.5%、86.7%、85.7%；p=0.031）。年龄和组织学是 RAS 突变的独立危险因素。RAS 突变是 I-III 期 CRC 患者无复发生存的独立预后因素。
在 I-III 期 CRC 患者中，KRAS 外显子 2 突变的预后最差，而 KRAS 野生型、外显子 3 突变、外显子 4 突变和 NRAS 突变的预后较好。
