结直肠癌KRAS基因突变与临床病理及实验室特征的关系分析  

Analysis of KRAS mutations in colorectal cancer and their clinical,pathological,and laboratory characteristics

作　　者：巴琴文 袁旭 王云[1] 鲁艳军[1] BA Qinwen;YUAN Xu;WANG Yun;LU Yanjun(Department of Clinical Laboratory,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030

出　　处：《国际检验医学杂志》2024年第24期3030-3034,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨结直肠癌患者克尔斯滕大鼠肉瘤(KRAS)基因突变情况与其临床病理及实验室特征的关系。方法KRAS基因突变检测采用突变扩增系统PCR(ARMS-PCR),将297例结直肠癌患者根据KRAS基因突变情况分为KRAS野生型(KRAS-WT)组与KRAS突变型(KRAS-MT)组。收集患者性别、年龄、原发部位、转移浸润、TMN分期、病理类型、分化程度、免疫组织化学及血清肿瘤标志物等资料,并进行统计学分析。结果297例结直肠癌患者中,KRAS基因总突变率为47.81%(142/297),其中第2号外显子上的位点突变率最高,占35.69%(106/297)。与KRAS-WT组比较,KRAS-MT组原发部位为右半结肠及女性患者占比更高(P<0.05)。第2号外显子突变组、第3、4号外显子突变组和KRAS-WT组在Ki67阳性细胞比例方面比较,差异有统计学意义(P<0.05)。第2号外显子突变组、第3、4号外显子突变组和KRAS-WT组血清CEA、CA199水平比较,差异均有统计学意义(P<0.05)。结论结直肠癌中KRAS基因突变类型与患者不同临床病理与实验室特征之间存在一定的相关性,可为结直肠癌临床诊疗提供线索。Objective To investigate the correlation between KRAS gene mutations and their clinical,pathological,and laboratory characteristics in patients with colorectal cancer.Methods KRAS gene mutation detection was performed using the Mutation Amplification System PCR(ARMS-PCR)method.297 colorectal cancer patients were divided into[KRAS wild-type(KRAS-WT)group and KRAS mutant type(KRAS-MT)group]based on their KRAS gene mutation status.Data on patient gender,age,primary site,metastatic infiltration,TMN staging,pathological type,differentiation degree,immunohistochemistry,and serum tumor markers were collected.Statistical analysis was performed.Results Among 297 colorectal cancer patients,the total mutation rate of KRAS gene was 47.81%(142/297),with the highest mutation rate at the locus on exon 2,accounting for 35.69%(106/297).Compared with the KRAS-WT group,the KRAS-MT group had a higher proportion of patients with the primary site being the right colon and females(P<0.05).There was a statistically significant difference in the proportion of Ki67 positive cells among the exon 2 mutation group,the exon 3 and 4 mutation group,and the KRAS-WT group(P<0.05).There were statistically significant differences in serum CEA and CA199 levels among the exon 2 mutation group,exon 3 and 4 mutation groups,and KRAS-WT group(P<0.05).Conclusion There is a certain correlation between KRAS gene mutation types in colorectal cancer and different clinical,pathological,and laboratory characteristics of patients,which could provide clues for the clinical diagnosis and treatment of colorectal cancer.

关 键 词：结直肠癌 KRAS 突变 临床病理特征 

分 类 号：R735.3[医药卫生—肿瘤]