Prediction of metachronous advanced colorectal neoplasia by KRAS mutation in polyps.

IF 5.8 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY United European Gastroenterology Journal Pub Date : 2024-11-01 Epub Date: 2024-10-13 DOI:10.1002/ueg2.12667
Alejandro Martínez-Roca, Joaquín Cubiella, Anabel García-Heredia, David Guill-Berbegal, Sandra Baile-Maxía, Carolina Mangas-Sanjuán, Noelia Sala-Miquel, Lucía Madero-Velazquez, Cristina Alenda, Pedro Zapater, Clara González-Núñez, Agueda Iglesias-Gómez, Laura Codesido-Prado, Astrid Díez-Martín, Michal F Kaminski, Rune Erichsen, Hans-Olov Adami, Monika Ferlitsch, María Pellisé, Øyvind Holme, Evelien Dekker, Michael Bretthauer, Rodrigo Jover
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Abstract

Background: The potential of molecular markers in the removed polys as reliable predictors of metachronous lesions is still uncertain.

Aim: Our aim was to evaluate the role of somatic mutations in KRAS in polyps of patients with high-risk adenomas to predict the risk of advanced polyps or colorectal cancer (CRC) within 3 years.

Methods: A total of 518 patients were prospectively enrolled. The included patients had adenomas ≥10 mm, high-grade dysplasia, villous component or ≥3 more adenomas at baseline and were scheduled to undergo surveillance colonoscopy at 3 years ± 6 months. Somatic KRAS mutation was performed on 1189 polyps collected from these patients. At surveillance, advanced lesions were defined as adenomas with a size of ≥10 mm. High-grade dysplasia or villous component, serrated polyps ≥10 mm or with dysplasia or CRC.

Results: At baseline, 81 patients (15.6%) had KRAS mutations in at least one polyp. Patients with KRAS mutated polyps had more frequent villous histological lesions and size ≥20 mm. In the multivariate analysis, adjusted for age and sex, only age (odds ratios [OR], 1.06; 95% confidence interval [CI], 1.02-1.09; p < 0.001), ≥5 adenomas (OR, 3.92; 95% CI, 1.96-7.82), and KRAS mutation (OR, 2.54; 95% CI, 1.48-4.34; p < 0.01) were independently associated with the development of advanced lesions at surveillance.

Conclusions: Our results show that, in patients with high-risk adenomas, the presence of somatic mutations in KRAS is an independent risk factor for the development of advanced metachronous polyps.

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通过息肉中的 KRAS 基因突变预测晚期大肠癌的发生。
背景:切除多发性息肉中的分子标记物作为可靠预测指标的潜力仍不确定:目的:我们的目的是评估高危腺瘤患者息肉中 KRAS 体细胞突变对预测 3 年内晚期息肉或结直肠癌(CRC)风险的作用:共有 518 名患者接受了前瞻性研究。纳入的患者基线时腺瘤≥10毫米、高级别发育不良、绒毛成分或腺瘤≥3个,并计划在3年±6个月时接受监测结肠镜检查。对从这些患者身上收集的 1189 个息肉进行了体细胞 KRAS 突变检测。监测时,晚期病变定义为大小≥10 毫米的腺瘤。高级别发育不良或绒毛成分、锯齿状息肉≥10 毫米或伴有发育不良或 CRC:基线时,81 名患者(15.6%)至少有一个息肉存在 KRAS 突变。KRAS突变息肉患者更常见绒毛组织学病变,息肉大小≥20毫米。在对年龄和性别进行调整后的多变量分析中,只有年龄(几率比[OR],1.06;95% 置信区间[CI],1.02-1.09;P 结论:我们的研究结果表明,KRAS 突变息肉患者的息肉多为绒毛状组织病变,且大小≥20 毫米:我们的研究结果表明,在高危腺瘤患者中,KRAS 体细胞突变是晚期变异性息肉发生的独立风险因素。
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来源期刊
United European Gastroenterology Journal
United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
10.50
自引率
13.30%
发文量
147
期刊介绍: United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
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