Nras、Braf、Kras、Pik3ca基因突变检测在大肠癌治疗和预后中的临床价值研究

The clinical value of Nras,Braf,Kras,Pik3ca gene mutation detection in the treatment and prognosis of colorectal cancer

目的研究Nras、Braf、Kras、Pik3ca基因突变与大肠癌临床病理特征之间的关系。方法随机选择我院2010年2月~2013年8月期间收治的240例大肠癌患者作为研究对象,取术后肿瘤组织标本,检测Nras、Braf、Kras、Pik3ca基因突变并分析其与大肠癌患者临床病理特征之间的关系。随访3年,分析Nras、Braf、Kras、Pik3ca基因突变与患者的3年生存率的关系。结果 240例患者Nras、Braf、Kras、Pik3ca基因突变分别占2.50%、7.92%、43.75%、4.17%。Kras突变合并Pik3ca突变占3.75%。Braf突变合并Pik3ca突变占0.42%。Kras突变合并Nras突变1例,占0.42%。Nras基因突变仅与患者的年龄有关(P<0.05)。Braf基因突变仅与患者的肿瘤原发部位、分化程度以及术后是否复发有关(P<0.05)。Kras基因突变仅与患者的年龄和病灶大小有关(P<0.05)。Pik3ca基因突变与患者的肿瘤原发部位、分化程度有关(P<0.05)。Nras、Braf、Kras和Pik3ca基因突变大肠癌患者的3年生存率均低于野生型,差异有统计学意义(P<0.05)。结论对大肠癌患者行Nras、Braf、Kras、Pik3ca基因突变检测可以为靶向治疗提供科学依据。

Objective To stucly the relationship between Nras, Braf, Kras, Pik3ca gene mutation and clinieopathological features of colorectal cancer. Methods A total of 240 patients with colorectal cancer who were treated in our hospital from February 2010 to August 2013 were selected. The tumor tissues were taken and the relationship between Nras, Braf, Kras, Pik3ca gene mutation and clinicopathological features of colorectal cancer were analyzed. The relationship between Nras, Braf, Kras, Pik3ca gene mutation and 3-year survival was analyzed for 3 years＇ follow-up. Results 240 cases of Nras, Braf, Kras, Pik3ca gene mutation accounted for 2.50%, 7.92%, 43.75%, 4.17%. Kras mutations combined with Pik3ea mutations accounted for 3.75%. Braf mutation combined with Pik3ca mutation accounted for 0.42%. Kras mutation combined with Nras mutation in 1 case, accounting for 0.42%. The mutation of Nras gene was related to the age of the patient（P〈0.05）. The mutations of Braf gene were related to the location of primary tumor, the degree of differ- entiation and postoperative recurrence（P〈0.05）. Kras gene mutations were associated with age and lesion size（P〈0.05）. Pik3ca gene mutation was associated with the primary site and differentiation of the tumor（P〈0.05）. The 3-year survival rates of patients with Nras, Braf, Kras and Pik3ca mutations were lower than those of wild type, the difference was sta- tistically significant （P〈0.05）. Conclusion Nras, Braf, Kras and Pik3ca mutations in patients with colorectal cancer can provide a scientific basis for targeted therapy.