结直肠癌不同病变阶段K-ras基因突变的研究  

K-ras mutations in colorectal cancer at different stages

作　　者：沈永奇[1] 叶韵斌[1] 郑雄伟[1] 力超[1] 陈强[1] 

机构地区：[1]福建医科大学教学医院,福建省肿瘤医院内科研究室,福州350014

出　　处：《肿瘤》2010年第2期134-137,共4页Tumor

摘　　要：目的:研究结直肠癌不同病变阶段K-ras基因变化及其对结直肠癌演变的影响。方法:提取20例结直肠癌患者的原发灶、淋巴结转移灶、远处转移灶、结直肠腺瘤和相应正常结直肠组织的DNA各20份,经PCR扩增,对产物进行基因序列分析。结果:正常结直肠组织均表达野生型K-ras基因,结直肠腺瘤、原发灶、淋巴结转移灶和远处转移灶的K-ras突变率分别为20.0%(4/20)、30.0%(6/20)、25.0%(5/20)和30.0%(6/20),有3例远处转移灶出现复合突变。在发生K-ras突变的标本中,结直肠腺瘤、淋巴结转移灶、远处转移灶的突变类型与原发灶的一致性分别为0%(0/4)、40.0%(2/5)和50.0%(3/6)。结论:结直肠腺瘤、淋巴结转移灶和远处转移灶不宜作为临床检测K-ras突变的常规标本,但在无法获得原发灶标本时,淋巴结转移灶和远处转移灶的检测结果也有一定的参考价值;结直肠癌发生、发展的过程中,K-ras基因可能在多阶段发生多次不同的突变。Objective：To study the alteration of K-ras mutations in different stages of colorectal cancer（CRC） and its influence on the progression of CRC. Methods：The 20 paraffin-embedded tissues,including primary foci,metastatic lymph nodes,remoter metastatic foci,colorectal adenoma,and normal colorectal tissues,were collected from 20 patients with colorectal cancer. The sequence of PCR-amplified products were analyzed. Results：The wild K-ras gene was expressed in normal colorectal tissues. The mutation frequency of K-ras gene was 20.0% （4/20） in colorectal adenoma,30.0% （6/20） in primary foci,25.0% （5/20） in metastatic lymph nodes,and 30% （6/20） in remote metastatic lesions. In the samples with K-ras mutations,the consistency of the types of K-ras mutations between primary foci and colorectal carcinoma,lymph node metastatic lesions,remote metastatic lesions was 0.0%（0/4）,40.0%（2/5）,and 50.0%（3/6）,respectively.Conclusion：The colorectal adenoma,metastatic lymph nodes and remote metastatic lesions were not suited for K-ras analysis as routine samples in clinical practice. If the samples of primary lesions were not available,the detection results of metastatic lymph nodes and remote metastatic remote lesions will provide some reference values. K-ras gene had several different mutations in the progression of CRC.

关 键 词：结直肠肿瘤 基因 RAS 突变 DNA突变分析 

分 类 号：R735.3[医药卫生—肿瘤]