Bagrezaei Fahmideh, Gargari Bahram Pourghassem, Zamiri Reza Eghdam, Safaiyan Abdolrasoul, Alizadeh Mohammad
Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Attar Nishabouri St, POBOX: 14711, Tabriz, 5166614711, Iran.
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Cancer. 2025 Jan 28;25(1):158. doi: 10.1186/s12885-025-13538-w.
The mutation of the KRAS (Kirsten rat sarcoma virus) gene is a prevalent genetic alteration in metastatic colorectal cancer (mCRC). According to previous research, this mutation significantly affects clinical outcomes and quality of life (QOL). This research investigated the association between KRAS mutant status and various aspects of QOL in mCRC patients.
This case-control study involved 90 admitted patients with mCRC. The patients were either mCRC with positive KRAS mutants (case group) or those without the mutation (control group). The KRAS mutation status of each patient was determined using standard molecular testing. The QOL was evaluated through validated questionnaires from the European Organization for Research and Treatment of Cancer (EORTC), including QLQ-C30 and the QLQ-CR29 questionnaire for colorectal cancer patients. Differences in QOL between the groups and the association of QOL with the odds of KRAS mutation were analyzed using appropriate statistical tests.
Patients in the wild-type KRAS group had significantly higher scores on the global health status (GHS) of the QLQ-C30 scale compared to those with a KRAS mutation [(64.26 ± 4.63 vs. 49.63 ± 4, crude; p = 0.019, adjusted; p = 0.024). The mean score of the social functioning scale of the KRAS mutation group was significantly higher than the wild-type [(40 ± 5.84 vs. 24.81 ± 4.39, crude; p = 0.040, adjusted; p = 0.021)]. Based on the QLQ-CR29 questionnaire, average QOL scores were suboptimal for both groups but insignificant. Further, both crude and adjusted analyses showed that KRAS mutation odds were significantly linked to improved social functioning [(crude; OR = 1.013; P = 0.044), (adjusted; OR = 1.017; P = 0.019)] and negatively associated with GHS [(crude; OR = 0.983; P = 0.022), (adjusted; OR = 0.982; P = 0.022)].
The study revealed a low QOL in mCRC, a notable difference in social functioning, and the GHS among patients with and without mutations. Further research is needed to develop targeted interventions to enhance QOL in patients with KRAS mutation.
KRAS（ Kirsten大鼠肉瘤病毒）基因的突变是转移性结直肠癌（mCRC）中一种常见的基因改变。根据先前的研究，这种突变显著影响临床结果和生活质量（QOL）。本研究调查了mCRC患者KRAS突变状态与生活质量各方面之间的关联。
本病例对照研究纳入了90例入院的mCRC患者。患者分为KRAS突变阳性的mCRC患者（病例组）和无突变患者（对照组）。使用标准分子检测确定每位患者的KRAS突变状态。通过欧洲癌症研究与治疗组织（EORTC）验证的问卷评估生活质量，包括QLQ-C30和针对结直肠癌患者的QLQ-CR29问卷。使用适当的统计检验分析两组之间生活质量的差异以及生活质量与KRAS突变几率的关联。
KRAS野生型组患者在QLQ-C30量表的总体健康状况（GHS）上的得分显著高于KRAS突变患者组[（64.26±4.63对49.63±4，未校正；p = 0.019，校正后；p = 0.024）]。KRAS突变组的社会功能量表平均得分显著高于野生型组[（40±5.84对24.81±4.39，未校正；p = 0.040，校正后；p = 0.021）]。根据QLQ-CR29问卷，两组的平均生活质量得分均不理想，但差异不显著。此外，未校正和校正分析均显示，KRAS突变几率与改善的社会功能显著相关[（未校正；OR = 1.013；P = 0.044），（校正后；OR = 1.017；P = 0.019）]，与GHS呈负相关[（未校正；OR = 0.983；P = 0.022），（校正后；OR = 0.982；P = 0.022）]。
该研究揭示了mCRC患者生活质量较低，有突变和无突变患者在社会功能和总体健康状况方面存在显著差异。需要进一步研究以制定针对性干预措施，提高KRAS突变患者的生活质量。
