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综合基因组分析确定了伴有肝转移的结直肠癌患者的临床相关预后标志物。

Integrative genomic analysis identifies clinically relevant prognostic markers for colorectal cancer patients with liver metastasis.

作者信息

Li Wentao, Liu Ming, Wu Liula, Zhu Bosen, Li Xiangtao, Yang Ziyi, Liang Yi, Lin Junqiong

机构信息

Department of Gastroenteroanal Surgery, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.

HaploX Biotechnology, Shenzhen, China.

出版信息

Clin Transl Oncol. 2025 Aug 29. doi: 10.1007/s12094-025-04021-w.


DOI:10.1007/s12094-025-04021-w
PMID:40880011
Abstract

PURPOSE: Colorectal liver metastases (CRLM) pose a significant clinical challenge due to their high recurrence rates, even after surgical resection. There is an urgent need for reliable prognostic biomarkers to improve risk stratification and guide treatment decisions for CRLM patients. METHODS/PATIENTS: In this study, we performed whole-exome sequencing (WES) on 57 CRLM patients and conducted a comparative genomic analysis of primary tumors and matched liver metastases in 8 patients. We systematically identified prognostic factors associated with overall survival (OS) and developed a predictive nomogram for CRLM patients. RESULTS AND CONCLUSIONS: The most frequently mutated genes in our cohort were APC (64.91%) and TP53 (64.91%), followed by KRAS (50.88%), PIK3CA (24.56%), and SMAD4 (24.56%). Pathway analysis revealed significant enrichment in p53, IGF, and Ras signaling pathways. Notably, primary and metastatic lesions exhibited high mutational concordance. Multivariate analysis identified five independent prognostic factors for OS: number of metastasis-positive lymph node stations in primary resected tumor tissue, mutational status of ZNF717 and MUC2, APC mutation status, and chr9p13.3 amplification. The nomogram integrating these factors achieved a C index of 0.798 for OS prediction. Our findings suggest that integrating genomic profiling into clinical practice could enhance prognostic assessment and optimize treatment stratification for CRLM patients.

摘要

目的:结直肠癌肝转移(CRLM)即使在手术切除后仍具有较高的复发率,给临床带来了重大挑战。迫切需要可靠的预后生物标志物来改善风险分层并指导CRLM患者的治疗决策。 方法/患者:在本研究中,我们对57例CRLM患者进行了全外显子组测序(WES),并对8例患者的原发性肿瘤和匹配的肝转移灶进行了比较基因组分析。我们系统地确定了与总生存期(OS)相关的预后因素,并为CRLM患者开发了预测列线图。 结果与结论:我们队列中最常发生突变的基因是APC(64.91%)和TP53(64.91%),其次是KRAS(50.88%)、PIK3CA(24.56%)和SMAD4(24.56%)。通路分析显示p53、IGF和Ras信号通路有显著富集。值得注意的是,原发性和转移性病变表现出高度的突变一致性。多变量分析确定了OS的五个独立预后因素:原发性切除肿瘤组织中转移阳性淋巴结站的数量、ZNF717和MUC2的突变状态、APC突变状态以及chr9p13.3扩增。整合这些因素的列线图在OS预测方面的C指数为0.798。我们的研究结果表明,将基因组分析纳入临床实践可以增强CRLM患者的预后评估并优化治疗分层。

相似文献

[1]
Integrative genomic analysis identifies clinically relevant prognostic markers for colorectal cancer patients with liver metastasis.

Clin Transl Oncol. 2025-8-29

[2]
Clinical significance and prognostic relevance of KRAS, BRAF, PI3K and TP53 genetic mutation analysis for resectable and unresectable colorectal liver metastases: A systematic review of the current evidence.

Surg Oncol. 2018-6

[3]
The challenge of molecular selection in liver-limited metastatic colorectal cancer for surgical resection: a systematic review and meta-analysis in the context of current and future approaches.

Oncol Res. 2024

[4]
Effect of KRAS and BRAF Mutations on Survival of Metastatic Colorectal Cancer After Liver Resection: A Systematic Review and Meta-Analysis.

Clin Colorectal Cancer. 2017-1-25

[5]
Are Current Survival Prediction Tools Useful When Treating Subsequent Skeletal-related Events From Bone Metastases?

Clin Orthop Relat Res. 2024-9-1

[6]
Clinical and molecular heterogeneity associated with tumor sidedness in colorectal liver metastasis: a multicenter propensity cohort study.

Hepatobiliary Surg Nutr. 2024-4-3

[7]
Synthetic tumor extracellular volume as a predictive biomarker for colorectal liver metastasis patients prior to curative hepatectomy.

Eur Radiol. 2025-3-24

[8]
Systemic treatments for metastatic cutaneous melanoma.

Cochrane Database Syst Rev. 2018-2-6

[9]
Transarterial (chemo)embolisation versus systemic chemotherapy for colorectal cancer liver metastases.

Cochrane Database Syst Rev. 2024-8-9

[10]
Dynamic Prognostic Models for Colorectal Cancer With Liver Metastases.

JAMA Netw Open. 2025-8-1

本文引用的文献

[1]
ScRNAPip: A systematic and dynamic pipeline for single-cell RNA sequencing analysis.

Imeta. 2023-8-31

[2]
Mutational Status of and Affects Clinical Outcome in -Mutated Metastatic Colorectal Cancer.

Cancers (Basel). 2022-11-30

[3]
Clinical management of metastatic colorectal cancer in the era of precision medicine.

CA Cancer J Clin. 2022-7

[4]
Prognostic Factors of Colorectal Cancer: A Comparative Study on Patients With or Without Liver Metastasis.

Front Oncol. 2021-12-21

[5]
Mutated DNA Damage Repair Pathways Are Prognostic and Chemosensitivity Markers for Resected Colorectal Cancer Liver Metastases.

Front Oncol. 2021-3-31

[6]
The molecular origin and taxonomy of mucinous ovarian carcinoma.

Nat Commun. 2019-9-2

[7]
Discovery of Aberrant Alteration of Genome in Colorectal Cancer by Exome Sequencing.

Am J Med Sci. 2019-8-1

[8]
The landscape of genomic copy number alterations in colorectal cancer and their consequences on gene expression levels and disease outcome.

Mol Aspects Med. 2019-8-6

[9]
Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing?

J Gastrointest Surg. 2018-4-11

[10]
Biomarkers in colorectal liver metastases.

Br J Surg. 2018-3-26

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