Waike lilun yu shijian (Jan 2021)

KRAS genotypes predict metachronous colorectal cancer distant metastases after radical resections

  • LIN Songbin, FENG Qingyang, XU Jianmin

DOI
https://doi.org/10.16139/j.1007-9610.2021.01.014
Journal volume & issue
Vol. 26, no. 01
pp. 66 – 71

Abstract

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Objective To explore the relationship between KRAS genotype and metachronous distant metastases in patients with colorectal cancer after radical resections. Methods Patients were analyzed retrospectively with metachronous distant metastases group and non-metastases group. PCR and pyrosequencing were used to detect the genotype of KRAS. Clinicopathological data and the KRAS genotype were analyzed to find the predictor for metachronous distant metastases. Results A total of 186 patients were enrolled in this study: 93 cases in metachronous distant metastases group and 93 cases in non-metastases group. KRAS gene mutation type was significantly associated with preoperative CEA(P=0.015) and metachronous distant metastases (P<0.001). The multivariate analyses showed that female (OR=0.426, P=0.020), tumor located at rectum (OR=0.408, P=0.040) and the type of mucinous adenocarcinoma (OR=0.230, P=0.010) were independent protective factors for metachronous distant metastases. Pathological N2 stage (OR=4.191, P=0.003), KRAS mutation type of p.G12V (OR=10.568, P=0.001) and p.G13D (OR=12.657, P<0.001) were 2 independent risk factors for metachronous distant metastases. The model of multivariate prediction was gotten based on 5 factors and was significantly better than prediction of single factor with TNM stage or KRAS genotype (multivariate model, AUC=0.767; TNM stage, AUC=0.569; KRAS genotype, AUC=0.628; P<0.001). Conclusions p.G12V and p.G13D mutation type of KRAS gene were independent risk factors for metachronous distant metastases. Multivariate prediction model was constructed for prediction of metachronous colorectal cancer distance metastases.

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