摘要
目的探讨直肠癌术后患者KRAS基因突变和临床因素对术后预后可能的影响及价值。方法收集2010年1-12月我院接受手术的直肠癌患者130例,采用直接测序法检测患者肿瘤组织KRAS基因突变情况并进行为期5年的随访,分析KRAS基因突变与临床病理因素的关系,对可能影响预后的因素进行分析。结果 KRAS基因2号外显子突变患者45例,突变率为34.6%,KRAS基因突变与表皮生长因子受体(EGFR)更强的阳性表达及与肿瘤的多发转移差异有统计学意义(P<0.05)。野生型KRAS基因术后患者平均生存57.5个月,突变型Kras基因术后患者平均生存58.9个月,差异无统计学意义(P>0.05)。TNM高分期、癌细胞的多发转移、肝转移和肺转移与患者的手术预后不良有关(P<0.05),Ⅳ期患者手术切除后平均生存达49个月。结论手术后直肠癌患者KRAS基因突变与EGFR更强的阳性表达和肿瘤的多发转移有关,TNM高分期、转移部位影响手术预后,Ⅳ期直肠癌术后有延长生存趋势,尚不能确定KRAS基因突变与直肠癌患者手术预后的关系。
Objective To investigate the effect of KRAS gene mutation and clinical factors on postoperative prognosis of rectal cancer patients and to explore their value in prognosis. Methods A total of 130 cases of rectal cancer patients from January to December 2010 were collected in the study. The tumor tissues sample was used to detect the KRAS gene mutation and 5-year follow-up was conducted. The correlation between KRAS gene mutation and clinical pathological features was analyzed. The clinic pathological factors that may affect the prognosis were analyzed by survival analysis. Results Forty-five patients had mutations in No.2 expressed region of KRAS, with a mutation rate of 34.6%. KRAS gene mutation and stronger positive expression of EGFR （P 〈 0.05）, and multiple metastasis of tumor （P 〈 0.05） were strongly coupled. The average survival of patients with wild-type KRAS gene was 57.5 months and that of patients with KRAS gene mutation 58.9 months but no significant difference was observed （P 〉 0.05）. The TNM by high staging, multiple metastasis, lung metastasis and liver metasta- sis of cancer cells was closely related with poor postoperative prognosis of patients （P 〈 0.05 ）. The average survival of postoperative patients in stage Ⅳ was 49months. Conclusions KRAS gene mutation in patients with rectal cancer after surgery is related with stronger positive expression of EGFR and multiple metastasis of cancer. TNM by high staging and metastatic sites affects the prognosis. The survival of rectal cancer after surgery in patients with stage IV are prolonged but the relation between KRAS genovariation and patients＇ postoperative prognosis can not be determined.
出处
《实用医学杂志》
CAS
北大核心
2018年第3期362-366,共5页
The Journal of Practical Medicine
基金
广东省科技计划项目(编号：2013B021800198)
广东省医学科学技术研究基金项目(编号：B2017122)
关键词
KRAS基因突变
直肠癌手术
术后预后
临床因素
KRAS gene mutation
rectal cencer surgery
postoperative prognosis
clinical characteristics
