PI3K突变与出现镶嵌血管的结直肠癌远处转移

PI3K mutation and distant metastasis of colorectal cancer with mosaic vessels

目的 探讨出现镶嵌血管的结直肠癌中癌细胞PI3K的突变与结直肠癌远处转移间的关系.方法 收集手术切除,并经免疫组织化学染色证实存在镶嵌血管的168例结直肠癌标本;PCR测序鉴别PI3K突变,并分析其临床、病理与随访资料,进而探讨PI3K突变在出现镶嵌血管的结直肠癌远处转移中的意义.结果 168例出现镶嵌血管的结直肠癌标本,其PI3K突变率为25.0％,外显子9突变率为15.5％,外显子20突变率为9.5％.56例患者术前即出现远处转移,其中发生PI3K突变的为20例,其远处转移率为47.6％,而未出现PI3K突变的36例,其远处转移率为28.6％,两者差异有统计学意义.随访中,发生PI3K突变的复发率及复发伴转移率与未发生PI3K突变相比,其差异均有统计学意义.结论 PI3K突变为出现镶嵌血管结直肠癌转移的相关影响因子之一,在出现镶嵌血管的结直肠癌中检测PI3K基因的突变有利于进一步判断患者预后.

Objective To explore the relationship between PI3K mutation and distant metastasis in colorectal cancer（CRC） with mosaic vessels.Methods A total of 168 surgical specimens of CRC with mosaic vessels were collected and confirmed with immunohistochemistry.Polymerase chain reaction（PCR） and direct sequencing were applied to identify the mutation of PI3K.Clinical,pathological and follow-up data were also analyzed to explore the significance of PI3K mutation in CRC with mosaic vessels.Results In the 168 CRC specimens with mosaic vessels,the mutation rate of PI3K was 25％,including 15.5％ of Exon 9 mutation and 9.5％ of Exon 20 mutation.In the 56 cases with preoperative distant metastasis,20 cases with PI3K mutation had a metastasis rate of 47.6％ and 36 cases without PI3K mutation had a metastasis rate of 28.6％,which was significantly different.During the follow-up period,the recurrence and metastasis rates of patients with and without mutation of PI3K were significantly different.Conclusion Mutation of PI3K is a related factor to the metastasis of CRC with mosaic vessels.Detecting PI3K mutation in CRC with mosaic vessels is helpful for further judgment of prognosis.