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目的探讨新疆维吾尔族(维族)、汉族结直肠癌伴肝转移患者中KRAS基因及BRAF基因突变差异及其与临床病理特征和预后的关系。方法选择新疆医科大学第一附属医院2005年1月-2010年12月收治的100例新疆维、汉族结直肠癌伴肝转移患者,应用PCR及Pyrosequencing测序法检测分析KRAS基因及BRAF基因突变情况,分析其与临床病理特征和预后的关系。结果维、汉族结直肠癌伴肝转移患者的KRAS与BRAF基因突变率分别为28%(28/100)与5%(5/100)。50例汉族患者中KRAS基因突变18例,BRAF基因突变2例;50例维吾尔族患者中KRAS基因突变10例,BRAF基因突变3例。原发肿瘤组织学分级、区域淋巴结转移、脉管瘤栓、肝外侵犯或转移、KRAS和BRAF为结直肠癌的预后影响因素(P<0.05);多因素分析显示,脉管瘤栓(P=0.035)、KRAS基因(P=0.001)为结直肠癌的独立的预后因素。结论在新疆维、汉族结直肠癌伴肝转移患者中,脉管瘤栓及KRAS基因具有主要的预后价值。积极检测KRAS基因,可望延长患者生存期。
Objective To investigate the difference of KRAS gene and BRAF gene mutation between Uygur (Uygur) and Han patients with colorectal cancer and liver metastasis in Xinjiang and its relationship with clinicopathological features and prognosis. Methods 100 cases of patients with colorectal cancer with liver metastasis from January 2005 to December 2010 admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2005 to December 2010 were enrolled in this study. Mutations of KRAS gene and BRAF gene were detected by PCR and Pyrosequencing. Analyze its relationship with clinicopathological features and prognosis. Results The mutation rates of KRAS and BRAF in patients with colorectal cancer and liver metastasis in Han nationality were 28% (28/100) and 5% (5/100) respectively. In 50 Han patients, KRAS gene mutations were found in 18 cases and BRAF gene mutations in 2 cases. Among 50 cases of Uyghur patients, KRAS gene mutations were found in 10 cases and BRAF gene mutations in 3 cases. KRAS and BRAF were the prognostic factors for colorectal cancer (P <0.05). Multivariate analysis showed that the presence of P (P = 0.035). The KRAS gene (P = 0.001) was an independent prognostic factor for colorectal cancer. Conclusion Among the patients with colorectal cancer with liver metastasis in Xinjiang and Han nationalities, the tumor thrombus and KRAS gene have the main prognostic value. Active detection of KRAS gene is expected to extend the survival of patients.