外周血中K-ras和p53基因突变对胃癌术后复发转移的预测价值

Prognostic value of K-ras and p53 gene mutations in peripheral blood for postoperative recurrence and metastasis of gastric cancer

[目的]探讨外周血K-ras和p53基因突变对胃癌根治术患者术后复发转移的预测价值。[方法]纳入2010年1月~2013年12月于我院接受胃癌根治术的107例患者为对象,对其持续随访,并分别于化疗前后取外周血标本。另于2017年3月~5月募集健康志愿者38例,取外周血标本。采用聚合酶链反应-单链构象多态性分析(PCR-SSCP)技术检测标本K-ras和p53基因突变情况。观察上述基因突变与胃癌患者临床病理特征及复发转移的关系。[结果]107例患者中,共54例复发转移,发生率50.47%;化疗前p53基因突变30例,占28.04%,K-ras基因突变35例,占32.71%。健康志愿者均未能检出p53与K-ras基因突变。K-ras与p53基因突变受化疗影响较轻,且与性别、年龄、手术方案等临床资料无明显关系(P>0.05)。化疗前外周血中检出p53和K-ras基因突变的患者术后无病生存时间明显更短(P<0.05),两基因突变均是患者术后复发转移的独立危险因素(OR=3.785,2.983;P<0.05)。化疗前K-ras基因突变对预测复发转移的敏感度0.556、特异度0.906;化疗前p53基因突变对预测复发转移的敏感度0.481、特异度0.924。[结论]胃癌根治术患者术后化疗前外周血中K-ras和p53基因突变检出率较高,且存在上述基因突变患者更易出现复发转移。

[Objective]To investigate the prognostic value of peripheral blood K-ras and p53 gene muta- tions for cancer recurrence and metastasis in patients with gastric cancer after radical resection. [Methods] 107 patients with gastric cancer treated with radical resection from January 2010 to December 2013 were in- volved and followed up. Their peripheral blood were sampled before and after chemotherapy respectively. In addition,38 healthy volunteers were collected from March to May in 2017,whose peripheral blood samples were taken during medically examination. The K-ras and p53 gene mutations in specimens were detected by Polymerase chain reaction-single strand conformation polymorphism （PCR-SSCP）. The relationship be- tween the gene mutation and clinicopathological features,recurrence and metastasis in patients with gastric cancer were observed. I-Results]54 out of the involved 107 cases were observed recurrence and metastasis, the incidence rate was 50.47%. Before chemotherapy,p53 gene mutation was found in 30 cases（28. 04%）. K-ras gene mutation was found in 35 cases（32.71%）. No p53 and K-ras gene mutation was found in health- y volunteers. K-ras and p53 gene mutations were rarely affected by chemotherapy,and were not significant- ly related to gender,age,surgical protocol and other clinical data（P〉0.05）. Disease free survival time was