探索伊朗结直肠癌患者的 KRAS、NRAS 和 BRAF 基因突变与临床特征之间的关系

IF 1.6 Q4 ONCOLOGY Journal of Gastrointestinal Cancer Pub Date : 2024-09-01 Epub Date: 2024-05-06 DOI:10.1007/s12029-024-01064-0
Zahra Mosaferi, Majid Pirestani, Ehsan Arefian, Goli Gojani, Nastaran Kavousinasab, Parto Karimi, Azam Deilami, Zahra Abrehdari-Tafreshi
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引用次数: 0

摘要

背景:结直肠癌患者可从抗表皮生长因子受体(EGFR)疗法中获益。然而,这种疗法对治疗 KRAS、NRAS 和 BRAF 基因发生组成性激活突变的结直肠癌无效。肿瘤组织的分子分析经常为结直肠癌的治疗决策提供依据。本研究旨在确定伊朗确诊结直肠癌患者的 KRAS、NRAS 和 BRAF 基因突变,并评估这些突变在这些人群中相对于肿瘤分化阶段的发生率:从 2018 年 4 月至 2022 年 12 月,收集了 2000 例结直肠癌患者的标本。记录了所有样本的性别、年龄和肿瘤分化阶段数据。为了检测突变,使用 Diatech 试剂盒扩增 KRAS 和 NRAS 外显子(2、3 和 4),并使用特异性引物扩增 BRAF 外显子 15。然后进行热测序:结果:样本分析显示,1105 份样本(55.3%)至少含有一个筛选基因的突变。在所研究的基因中,发生率最高的是 KRAS 基因突变,占 47.4%,其次是 NRAS 基因突变,占 5.3%,BRAF 基因突变占 2.7%。大多数 KRAS 突变发生在第 2 外显子(89.7%),其中以 G12D 突变最为普遍,占 32%。女性的 KRAS 突变率(52.5%)与男性(43.5%)相比有明显差异(P = 0.02)。就 NRAS 而言,大多数突变发生在第 3 外显子(76.2%),其中 Q61H 突变最为普遍,占 28.5%。临床病理参数与突变之间无明显关联:研究结果表明,在伊朗,这些基因突变的频率在不断上升,这突出表明需要筛查所有三个基因主要外显子的突变,以制定有效的结直肠癌治疗策略。
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Exploring the Relationship Between KRAS, NRAS, and BRAF Mutations and Clinical Characteristics in Iranian Colorectal Cancer Patients.

Background: Patients with colorectal cancer can benefit from anti-EGFR (epidermal growth factor receptor) therapy. However, this therapy is not effective for treating colorectal cancers with constitutive activating mutations in the KRAS, NRAS, and BRAF genes. Molecular analysis of tumor tissue frequently informs treatment decisions for colorectal cancer. This study aims to identify KRAS, NRAS, and BRAF mutations in Iranian patients diagnosed with colorectal cancer and to assess the prevalence of these mutations relative to the tumor differentiation stage within these populations.

Methods: From April 2018 to December 2022, 2000 specimens from patients with colorectal cancer were collected. Data on sex, age, and tumor differentiation stage were recorded for all samples. For mutation detection, the KRAS and NRAS exons (2, 3, and 4) were amplified using the Diatech kit, and a specific primer was used to amplify BRAF exon 15. Pyrosequencing was then performed.

Results: Analysis of samples revealed that 1105 specimens (55.3%) contained mutations in at least one of the screened genes. Among the genes studied, the highest occurrence was the KRAS mutation at 47.4%, followed by NRAS at 5.3% and BRAF at 2.7%. Most KRAS mutations were found in exon 2 (89.7%), with the G12D mutation being the most prevalent at 32% of cases. There was a significant difference in the rate of KRAS mutations in women (52.5%) compared to men (43.5%) (P =  0.02). For NRAS, the majority mutations were observed in exon 3 (76.2%), with the Q61H mutation being the most prevalent at 28.5% of cases. There were no significant associations between the clinicopathological parameters and mutations.

Conclusion: The study's findings indicate a rising frequency of mutations in these genes in Iran, highlighting the need to screening mutations in the main exons of all three genes for effective colorectal cancer treatment strategies.

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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
121
期刊介绍: The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology:  This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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