晚期结直肠癌患者血浆cfDNA中K-RAS突变及与西妥昔单抗耐药的关系研究  

Relationship Between the K-RAS Mutation of cfDNA in Plasma and Cetuximab Resistance in Patients with Advanced Colorectal Cancer

作　　者：林琳[1] 庞雄昊[1] 梁文丽 李美香[1] Lin Lin;Pang Xionghao;Liang Wenli;Li Meixiang(Department of Oncology, Shenzhen No. 2 People1＇s Hospital, Shenzhen, Guangdong,china 518037)

机构地区：[1]广东省深圳市第二人民医院肿瘤科,广东深圳518037

出　　处：《中国药业》2018年第11期8-11,共4页China Pharmaceuticals

基　　金：广东省深圳市卫生计生系统科研项目[201507018]

摘　　要：目的探讨晚期结直肠癌患者cfDNA中K-RAS的含量变化,以及K-RAS与结直肠癌患者用药的关系及其预后价值。方法选取晚期结直肠癌患者100例,从EDTA血液样品获得血浆,使用ARMS-PCR评估K-RAS突变等位基因,收集病例,并统计K-RAS突变状态与表皮生长因子受体(EGFR)单抗的药物疗效关系,分析K-RAS基因突变对总生存期(OS)和无疾病生存期(PFS)的影响。结果 cfDNA和组织中均检测出的K-RAS突变的一致性为62.50%,治疗前K-RAS在cfDNA中的突变丰度为(17.00±12.05)%,经过标准治疗后为(8.10±7.98)%;同样,在组织中检测出,治疗前K-RAS在组织中的突变丰度为(26.40±9.80)%,经过标准治疗后为(12.60±2.55)%;K-RAS野生型患者在使用EGFR单抗中会随着疾病的进展而出现K-RAS突变丰度增多的现象,且K-RAS的表达情况与临床PFS和OS正相关。结论血浆中K-RAS检测可指导临床用药,具有一定预后判断价值。Objective To investigate the K-RAS content changes of cfDNA in patients with advanced colorectal cancer,and the relationship between K-RAS and drug use and its prognostic value. Methods Totally 40 patients with advanced colorectal cancer were selected, the plasma was obtained from EDTA blood samples, K-RAS mutations alleles were detected by ARMS-PCR. The patients were selected and the relationship between the K-RAS mutation status and the efficacy of EGFR monoclonal antibody was analyzed,the effects of K-RAS mutations on overall survival rate and disease free survival rate were analyzed. Results The consistency of K-RAS mutations detected in cfDNA and organizational was 62. 50%. The abundance of K-RAS mutations in cfDNA was（ 17. 00 ±12. 05） % before treatment,which was（ 8. 10 ± 7. 98） % after standard treatment. In the same way,the abundance of K-RAS mutations in the organization was（ 26. 40 ± 9. 80） % before treatment, which was（ 12. 60 ± 2. 55） % after standard treatment group. The abundance of K-RAS mutations was increased with the progress of disease in the use of EGFR monoclonal antibody in the K-RAS wild-typed patients,and the expression of K-RAS was positively correlated with clinical PFS and OS. Conclusion Detection of K-RAS in plasma can guide the clinical use of drugs and the value of prognosis.

关 键 词：结直肠癌 基因突变 K-RAS 西妥昔单抗 预后 

分 类 号：R969.4[医药卫生—药理学]