胆囊癌组织鼠类肉瘤病毒癌基因突变与其临床病理特征及预后的关系

The relationship between K- ras gene mutation with clinicopathological and prognosis in gallbladder carcinoma

目的探讨胆囊癌组织中鼠类肉瘤病毒癌基因（K-ras）突变及其与临床病理特征和生存预后的相关性。方法收集胆囊癌手术患者79例，提取胆囊癌组织DNA，采用纳米探针检测K-ras基因第12、13位点密码子突变，分析K-ras基因突变与临床病理特征的相关性，并分析K-ras基因突变对胆囊癌患者预后的影响。结果79例胆囊癌患者中K-ras基因突变率为63.3%（50/79），K-ras突变与临床分期、转移明显相关（P＝0.003、0.000）。生存分析结果显示K-ras基因突变组1年、2年无瘤生存率为67.9%、11.5%，野生组为88.3%、43.4%，差异均有统计学意义（P＝0.047、0.009）；K-ras基因突变组1年、2年总生存率为90.4%、43.0%，野生组为96.3%、70.6%，1年总生存率比较差异无统计学意义，2年总生存率比较差异有统计学意义（P＝0.044）。结论K-ras基因突变与胆囊癌的转移、不良预后明显相关。

Objective To investigate the mutation of K-ras gene in gallbladder cancer and its correlation with clinicopathological and prognosis.MethodsDNA from 79 gallbladder cancer who underwent curative resection. The mutation of K-ras gene codon 12 and 13 were detected by nano capture probe. To analyze the correlation between K-ras gene mutation and clinical and pathological indexes. The significance of K-ras gene mutation on the prognosis of patients with gallbladder carcinoma were also be analyzed.ResultsThe total K-ras mutation rate of 79 gallbladder cancer patients was 63.3% （50/79）. There were significant correlation between K-ras gene mutation and clinical stages and metastasis （P=0.003, P=0.000）. The cumulative one-year and two-year actuarial recurrence free survival rates of patients with K-ras mutation were 67.9% and 11.5%, and the cumulative one-year and two-year actuarial recurrence free survival rates of of patients with wild genotype were 88.3% and 43.4%, the differences are statistically significant（P=0.047, P=0.009）. The cumulative one-year and two-year overall survival rate of patients with K-ras mutation were 90.4% and 43.0%, The cumulative one-year and two-year overall survival rate of patients with K-ras wild genotype were 96.3% and 70.6%. there was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate （P=0.044）.ConclusionThe mutation of K-ras gene is significantly related to tumor metastasis and poor prognosis in gallbladder cancer.